Provider Demographics
NPI:1952440653
Name:ROSE, CYNTHIA WONG (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:WONG
Last Name:ROSE
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Gender:F
Credentials:LCSW
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Mailing Address - Street 1:1200 EL CAMINO REAL
Mailing Address - Street 2:3RD FL KAISER SOUTH SAN FRANCISCO OUTPATIENT PSYCHIATRY
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-3208
Mailing Address - Country:US
Mailing Address - Phone:650-742-3279
Mailing Address - Fax:650-742-2591
Practice Address - Street 1:333 TWIN DOLPHIN DR
Practice Address - Street 2:2ND FLR KAISER REDWOOD CITY INPATIENT PSYCHIATRY ADMIN
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94065-1401
Practice Address - Country:US
Practice Address - Phone:650-299-4112
Practice Address - Fax:650-299-2655
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2021-12-30
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Provider Licenses
StateLicense IDTaxonomies
CALCS128911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical