Provider Demographics
NPI:1629102793
Name:ROTHE, CYDNY ELAINE (MSW)
Entity Type:Individual
Prefix:MS
First Name:CYDNY
Middle Name:ELAINE
Last Name:ROTHE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 N OAK KNOLL AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-4174
Mailing Address - Country:US
Mailing Address - Phone:323-664-9217
Mailing Address - Fax:323-661-8942
Practice Address - Street 1:181 N OAK KNOLL AVE STE 4
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-4174
Practice Address - Country:US
Practice Address - Phone:323-664-9217
Practice Address - Fax:323-661-8942
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS52121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical