Provider Demographics
NPI:1851152011
Name:DILLON, CYNDI JENELLE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CYNDI
Middle Name:JENELLE
Last Name:DILLON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:JENELLE
Other - Last Name:DILLON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:25485 MEDICAL CENTER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6927
Mailing Address - Country:US
Mailing Address - Phone:909-992-0943
Mailing Address - Fax:
Practice Address - Street 1:25485 MEDICAL CENTER DR STE 104
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6927
Practice Address - Country:US
Practice Address - Phone:909-992-0943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35608235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist