Provider Demographics
NPI:1376324897
Name:HUSBAND, CYNTHIA (MS)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:HUSBAND
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 N 4TH ST UNIT 1211
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-6166
Mailing Address - Country:US
Mailing Address - Phone:951-240-6941
Mailing Address - Fax:
Practice Address - Street 1:370 WOOSTER AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1095
Practice Address - Country:US
Practice Address - Phone:408-217-8951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116117101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health