Provider Demographics
NPI:1528561610
Name:MCBRIDE, CYNTHIA LORETTA (FNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LORETTA
Last Name:MCBRIDE
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 1:506 COUCH ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-2408
Mailing Address - Country:US
Mailing Address - Phone:707-644-1761
Mailing Address - Fax:
Practice Address - Street 1:506 COUCH ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-2408
Practice Address - Country:US
Practice Address - Phone:707-644-1761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95007821363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily