Provider Demographics
NPI: | 1750338976 |
---|---|
Name: | TUMBLESON, CYNTHIA LYNN (DPT) |
Entity type: | Individual |
Prefix: | DR |
First Name: | CYNTHIA |
Middle Name: | LYNN |
Last Name: | TUMBLESON |
Suffix: | |
Gender: | F |
Credentials: | DPT |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 7722 COAST JAY ST |
Mailing Address - Street 2: | |
Mailing Address - City: | NORTH LAS VEGAS |
Mailing Address - State: | NV |
Mailing Address - Zip Code: | 89084-3743 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 951-237-3086 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 11470 TIFFANY LN |
Practice Address - Street 2: | |
Practice Address - City: | MORENO VALLEY |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92557-4706 |
Practice Address - Country: | US |
Practice Address - Phone: | 951-237-3086 |
Practice Address - Fax: | 951-243-0412 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-05-31 |
Last Update Date: | 2018-03-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | PT12358 | 2251N0400X, 2251C2600X, 2251E1200X, 2251G0304X, 2251H1200X, 2251X0800X, 225100000X, 2251P0200X, 2251S0007X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | |
No | 2251N0400X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology |
No | 2251C2600X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Cardiopulmonary |
No | 2251E1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Ergonomics |
No | 2251G0304X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics |
No | 2251H1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Hand |
No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
No | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | ZZZ24713Z | Medicare ID - Type Unspecified | PROVIDER # |