Provider Demographics
NPI:1558806992
Name:SAUCEDO, CYNTHIA DUENAS (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DUENAS
Last Name:SAUCEDO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3554 SUNSET LN UNIT 25
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92173-4506
Mailing Address - Country:US
Mailing Address - Phone:619-721-6485
Mailing Address - Fax:
Practice Address - Street 1:3554 SUNSET LN UNIT 25
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92173-4506
Practice Address - Country:US
Practice Address - Phone:619-721-6485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43534225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist