Provider Demographics
NPI:1619148590
Name:OBERSHAW, CYNTHIA PAGE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:PAGE
Last Name:OBERSHAW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 E POLK ST # 9
Mailing Address - Street 2:
Mailing Address - City:COALINGA
Mailing Address - State:CA
Mailing Address - Zip Code:93210-2311
Mailing Address - Country:US
Mailing Address - Phone:909-524-5762
Mailing Address - Fax:
Practice Address - Street 1:605 WASHINGTON ST APT C
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-1691
Practice Address - Country:US
Practice Address - Phone:909-524-5762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA227031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical