Provider Demographics
NPI:1457599805
Name:SPEICH, CYNTHIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:SPEICH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 N BEDFORD DR
Mailing Address - Street 2:SUITE 404
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4321
Mailing Address - Country:US
Mailing Address - Phone:310-777-2425
Mailing Address - Fax:310-388-5658
Practice Address - Street 1:435 N BEDFORD DR
Practice Address - Street 2:SUITE 404
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4321
Practice Address - Country:US
Practice Address - Phone:310-777-2425
Practice Address - Fax:310-388-5658
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18015103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical