Provider Demographics
NPI:1598885634
Name:LOMELI GARCIA, CYNTHIA SELENE (MA)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:SELENE
Last Name:LOMELI GARCIA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 E PALMDALE BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-2029
Mailing Address - Country:US
Mailing Address - Phone:661-272-9996
Mailing Address - Fax:
Practice Address - Street 1:1529 E PALMDALE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-2029
Practice Address - Country:US
Practice Address - Phone:661-272-9996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2024-04-17
Deactivation Date:2018-03-06
Deactivation Code:
Reactivation Date:2018-03-15
Provider Licenses
StateLicense IDTaxonomies
CAAMFT1051080101YM0800X
CAAMFT105180101YM0800X, 106H00000X
CAIMF69879101YM0800X
CAAMFT145929106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAIMF69879OtherMFT INTEREN