Provider Demographics
NPI:1528188331
Name:DUENAS, CYNTHIA (MFT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:DUENAS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W BRIGGSMORE AVE
Mailing Address - Street 2:SUITE I
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-3839
Mailing Address - Country:US
Mailing Address - Phone:209-579-5742
Mailing Address - Fax:209-526-0908
Practice Address - Street 1:2000 W BRIGGSMORE AVE
Practice Address - Street 2:SUITE I
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-3839
Practice Address - Country:US
Practice Address - Phone:209-579-5742
Practice Address - Fax:209-526-0908
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 32178106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist