Provider Demographics
NPI:1831496744
Name:DUNKERSON, CYNDIE JO (CADC II, CA-CCS)
Entity Type:Individual
Prefix:MISS
First Name:CYNDIE
Middle Name:JO
Last Name:DUNKERSON
Suffix:
Gender:F
Credentials:CADC II, CA-CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5230 CLARK AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-2619
Mailing Address - Country:US
Mailing Address - Phone:949-254-2727
Mailing Address - Fax:949-218-1597
Practice Address - Street 1:5230 CLARK AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-2619
Practice Address - Country:US
Practice Address - Phone:949-254-2727
Practice Address - Fax:949-218-1597
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-13
Last Update Date:2011-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA4980110101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)