Provider Demographics
NPI:1861478877
Name:SACLOLO, CYNTHIA D (RN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:D
Last Name:SACLOLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USNH YOKOSUKA JAPAN
Mailing Address - Street 2:PSC 475 BOX 1
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96322
Mailing Address - Country:JP
Mailing Address - Phone:0118146-816-8650
Mailing Address - Fax:
Practice Address - Street 1:PSC 476 BOX 25
Practice Address - Street 2:NBHC SASEBO JAPAN
Practice Address - City:FPO AP
Practice Address - State:CA
Practice Address - Zip Code:96322
Practice Address - Country:US
Practice Address - Phone:011-819-5650
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550283163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550283OtherRN LICENSE NUMBER