Provider Demographics
NPI:1710638341
Name:COSTLEY, CINDY
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:COSTLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:VICTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2814 YACHT WAY
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-1420
Mailing Address - Country:US
Mailing Address - Phone:805-813-0543
Mailing Address - Fax:
Practice Address - Street 1:1483 ALVA ST
Practice Address - Street 2:
Practice Address - City:CARPINTERIA
Practice Address - State:CA
Practice Address - Zip Code:93013-1501
Practice Address - Country:US
Practice Address - Phone:805-566-0299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health