Provider Demographics
NPI:1801624168
Name:LYNN, CADENCE MARIE
Entity type:Individual
Prefix:
First Name:CADENCE
Middle Name:MARIE
Last Name:LYNN
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 1:21236 MINNETONKA RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-7096
Mailing Address - Country:US
Mailing Address - Phone:760-223-9779
Mailing Address - Fax:
Practice Address - Street 1:21236 MINNETONKA RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-7096
Practice Address - Country:US
Practice Address - Phone:760-223-9779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician