Provider Demographics
NPI:1881865541
Name:KLEIN, CYNTHIA DAWN (HAS)
Entity Type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:DAWN
Last Name:KLEIN
Suffix:
Gender:F
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FILE #55745
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-5745
Mailing Address - Country:US
Mailing Address - Phone:760-721-1141
Mailing Address - Fax:760-721-0938
Practice Address - Street 1:3870 MISSION AVE
Practice Address - Street 2:D-5
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1880
Practice Address - Country:US
Practice Address - Phone:760-721-1141
Practice Address - Fax:760-721-0938
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7347237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist