Provider Demographics
NPI:1801036314
Name:MOTT, CYNITA DOMONIQUE (MASTERS)
Entity type:Individual
Prefix:
First Name:CYNITA
Middle Name:DOMONIQUE
Last Name:MOTT
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 GREENHAVEN DR STE 202
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-5640
Mailing Address - Country:US
Mailing Address - Phone:916-665-1804
Mailing Address - Fax:916-665-1807
Practice Address - Street 1:7600 GREENHAVEN DR STE 202
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-5640
Practice Address - Country:US
Practice Address - Phone:916-665-1804
Practice Address - Fax:916-665-1807
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)