Provider Demographics
NPI:1750970125
Name:BORDA DE LEON, CINTHYA ISAMAR
Entity type:Individual
Prefix:MISS
First Name:CINTHYA
Middle Name:ISAMAR
Last Name:BORDA DE LEON
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 1:6628 BECK AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-1715
Mailing Address - Country:US
Mailing Address - Phone:818-378-8952
Mailing Address - Fax:
Practice Address - Street 1:6628 BECK AVE APT 2
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1715
Practice Address - Country:US
Practice Address - Phone:818-378-8952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95204554163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse