Provider Demographics
NPI:1598539710
Name:HOPKINS, CYNTHIA MERCEDES (RDO, SLD, ABOC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MERCEDES
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:RDO, SLD, ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 18TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-4931
Mailing Address - Country:US
Mailing Address - Phone:661-348-4439
Mailing Address - Fax:
Practice Address - Street 1:402 18TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4931
Practice Address - Country:US
Practice Address - Phone:661-348-4439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43149156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA932550146OtherTAX ID