Provider Demographics
NPI:1376394767
Name:NAZARENO, CINDY ANN (HAD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:ANN
Last Name:NAZARENO
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 PLAZA PKWY STE 6
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-6215
Mailing Address - Country:US
Mailing Address - Phone:209-527-7729
Mailing Address - Fax:
Practice Address - Street 1:2225 PLAZA PKWY STE 6
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-6215
Practice Address - Country:US
Practice Address - Phone:209-527-7729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8975237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist