Provider Demographics
NPI:1457436099
Name:CANAS, CYNTHIA LOU (MFTI)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LOU
Last Name:CANAS
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10126 LA ALEGRIA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-3110
Mailing Address - Country:US
Mailing Address - Phone:916-382-9111
Mailing Address - Fax:
Practice Address - Street 1:10126 LA ALEGRIA DRIVE
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-3131
Practice Address - Country:US
Practice Address - Phone:916-382-9111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF71172106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA71172OtherMFTI