Provider Demographics
NPI:1356414775
Name:GERMAINE, CINDY PATTISON (MSSW)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:PATTISON
Last Name:GERMAINE
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:MRS
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:PATTISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSSW
Mailing Address - Street 1:790 LAUREL ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3164
Mailing Address - Country:US
Mailing Address - Phone:650-578-0103
Mailing Address - Fax:650-578-0103
Practice Address - Street 1:790 LAUREL ST
Practice Address - Street 2:SUITE 114
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3164
Practice Address - Country:US
Practice Address - Phone:650-578-0103
Practice Address - Fax:650-578-0103
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS58831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical