Provider Demographics
NPI:1922291392
Name:CERVANTES, CYNTHIA YVONNE (NURSE PRACTITIIONER)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:YVONNE
Last Name:CERVANTES
Suffix:
Gender:F
Credentials:NURSE PRACTITIIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1497 W SAN RAMON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3048
Mailing Address - Country:US
Mailing Address - Phone:559-432-6032
Mailing Address - Fax:559-433-8367
Practice Address - Street 1:1497 W SAN RAMON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3048
Practice Address - Country:US
Practice Address - Phone:559-432-6032
Practice Address - Fax:559-433-8367
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA439235363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health