Provider Demographics
NPI:1558631572
Name:MCQUADE, CINDY
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:MCQUADE
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 1:934-12TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA
Mailing Address - State:CA
Mailing Address - Zip Code:90403
Mailing Address - Country:US
Mailing Address - Phone:310-395-8721
Mailing Address - Fax:
Practice Address - Street 1:934-12TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA
Practice Address - State:CA
Practice Address - Zip Code:90403
Practice Address - Country:US
Practice Address - Phone:310-395-8721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS131161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical