Provider Demographics
NPI:1013053784
Name:THYGESON, CINDY YAEWON (MD)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:YAEWON
Last Name:THYGESON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YAE
Other - Middle Name:WON
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:755 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6708
Mailing Address - Country:US
Mailing Address - Phone:916-580-5769
Mailing Address - Fax:
Practice Address - Street 1:755 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6708
Practice Address - Country:US
Practice Address - Phone:916-580-5769
Practice Address - Fax:916-872-1311
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1083952084P0800X, 2084P0804X
MDD646422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry