Provider Demographics
NPI:1255674859
Name:ROSS, CINDY
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 SAN PABLO AVE
Mailing Address - Street 2:STE F
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2081
Mailing Address - Country:US
Mailing Address - Phone:510-724-1095
Mailing Address - Fax:510-724-1178
Practice Address - Street 1:1700 SAN PABLO AVE
Practice Address - Street 2:STE F
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2081
Practice Address - Country:US
Practice Address - Phone:510-724-1095
Practice Address - Fax:510-724-1178
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2870231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist