Provider Demographics
NPI:1376723338
Name:CAYONNE, ALTHEA C
Entity Type:Individual
Prefix:
First Name:ALTHEA
Middle Name:C
Last Name:CAYONNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7133 CUSTER WAY
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680-2817
Mailing Address - Country:US
Mailing Address - Phone:714-622-5685
Mailing Address - Fax:
Practice Address - Street 1:1500 E KAY ST
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-1752
Practice Address - Country:US
Practice Address - Phone:310-898-2450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health