Provider Demographics
NPI:1356789499
Name:LESTER, CYNTHIA GRACE (MSW)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:GRACE
Last Name:LESTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 N EDGEMONT ST APT 306
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5965
Mailing Address - Country:US
Mailing Address - Phone:917-648-9767
Mailing Address - Fax:
Practice Address - Street 1:1316 N EDGEMONT ST APT 306
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5965
Practice Address - Country:US
Practice Address - Phone:917-648-9767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA35935OtherASW#