Provider Demographics
NPI:1437370673
Name:GLOSS, CYNTHIAN JOHANNA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIAN
Middle Name:JOHANNA
Last Name:GLOSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 24 VIA MAJELLA
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-3629
Mailing Address - Country:US
Mailing Address - Phone:760-789-4222
Mailing Address - Fax:
Practice Address - Street 1:25 24 VIA MAJELLA
Practice Address - Street 2:
Practice Address - City:RAMONA
Practice Address - State:CA
Practice Address - Zip Code:92065-3629
Practice Address - Country:US
Practice Address - Phone:760-789-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAK0791232101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor