Provider Demographics
NPI:1609198415
Name:CALDEIRA, CYNTHIA (MFTI)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:CALDEIRA
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11555 LOS OSOS VALLEY RD
Mailing Address - Street 2:206
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-6472
Mailing Address - Country:US
Mailing Address - Phone:805-459-7168
Mailing Address - Fax:805-545-9909
Practice Address - Street 1:11555 LOS OSOS VALLEY RD
Practice Address - Street 2:206
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-6472
Practice Address - Country:US
Practice Address - Phone:805-459-7168
Practice Address - Fax:805-545-9909
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54019106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist