Provider Demographics
NPI:1689845372
Name:CYPRESS BEHAVORIAL HEALTH GROUP
Entity Type:Organization
Organization Name:CYPRESS BEHAVORIAL HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-890-2336
Mailing Address - Street 1:1911 COMMERCENTER E
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3454
Mailing Address - Country:US
Mailing Address - Phone:909-890-2336
Mailing Address - Fax:909-890-0896
Practice Address - Street 1:1911 COMMERCENTER E
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3454
Practice Address - Country:US
Practice Address - Phone:909-890-2336
Practice Address - Fax:909-890-0896
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CYPRESS MARRIAGE AND FAMILY COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32193101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty