Provider Demographics
NPI:1790101053
Name:CAMBERO, CYNTHIA R (CMT)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:R
Last Name:CAMBERO
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 N EL CAMINO REAL
Mailing Address - Street 2:SUITE C202
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1366
Mailing Address - Country:US
Mailing Address - Phone:951-704-4328
Mailing Address - Fax:
Practice Address - Street 1:499 N EL CAMINO REAL
Practice Address - Street 2:SUITE C202
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1366
Practice Address - Country:US
Practice Address - Phone:951-704-4328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40263225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist