Provider Demographics
NPI:1497126189
Name:SCAGGS, CYNTHIA CAROLINE
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:CAROLINE
Last Name:SCAGGS
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 1:593 BERRYHILL DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2002
Mailing Address - Country:US
Mailing Address - Phone:760-535-9760
Mailing Address - Fax:760-744-6657
Practice Address - Street 1:2821 OCEANSIDE BLVD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-4800
Practice Address - Country:US
Practice Address - Phone:760-721-2781
Practice Address - Fax:760-721-9571
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)