Provider Demographics
NPI:1730679457
Name:DARDIN-BOX, CINDI (LCSW)
Entity Type:Individual
Prefix:
First Name:CINDI
Middle Name:
Last Name:DARDIN-BOX
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 1:16389 AVENUE 152
Mailing Address - Street 2:
Mailing Address - City:TIPTON
Mailing Address - State:CA
Mailing Address - Zip Code:93272-9734
Mailing Address - Country:US
Mailing Address - Phone:559-350-2864
Mailing Address - Fax:
Practice Address - Street 1:900 QUEBEC AVE
Practice Address - Street 2:
Practice Address - City:CORCORAN
Practice Address - State:CA
Practice Address - Zip Code:93212-9715
Practice Address - Country:US
Practice Address - Phone:559-992-7100
Practice Address - Fax:559-992-7194
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA769161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty