Provider Demographics
NPI:1508226663
Name:RAYMOND, CYNTHIA DIANE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:DIANE
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 LANCASTER DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-2972
Mailing Address - Country:US
Mailing Address - Phone:626-379-8501
Mailing Address - Fax:
Practice Address - Street 1:821 LANCASTER DR
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-2972
Practice Address - Country:US
Practice Address - Phone:626-379-8501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003541363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily