Provider Demographics
NPI:1376614388
Name:WARD, CYNTHIA RENEE (DC)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:RENEE
Last Name:WARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:R
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:433 CALLAN AVE
Mailing Address - Street 2:STE. 104
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4643
Mailing Address - Country:US
Mailing Address - Phone:510-352-3535
Mailing Address - Fax:510-352-3659
Practice Address - Street 1:433 CALLAN AVE
Practice Address - Street 2:STE. 104
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4643
Practice Address - Country:US
Practice Address - Phone:510-352-3535
Practice Address - Fax:510-352-3659
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0269411Medicare ID - Type Unspecified