Provider Demographics
NPI:1497317556
Name:SAMAYOA, CYNTHIA SOFIA
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:SOFIA
Last Name:SAMAYOA
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 1:1650 GERRY CT
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-1359
Mailing Address - Country:US
Mailing Address - Phone:323-453-8260
Mailing Address - Fax:
Practice Address - Street 1:5451 AVENIDA DE LOS ROBLES, SUITE 102
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-2009
Practice Address - Country:US
Practice Address - Phone:559-372-2009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician