Provider Demographics
NPI:1831413269
Name:SAMBATARO, CYNTHIA (DOCTOR OF HEALTH PSY)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:SAMBATARO
Suffix:
Gender:F
Credentials:DOCTOR OF HEALTH PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21175 STATE HIGHWAY 249
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-1655
Mailing Address - Country:US
Mailing Address - Phone:819-665-2542
Mailing Address - Fax:
Practice Address - Street 1:11306 ERICSTON DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1345
Practice Address - Country:US
Practice Address - Phone:281-966-5254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-13
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT097.0135707101YP1600X, 202D00000X, 102L00000X
WACG60311352 PEND174400000X
1744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No174400000XOther Service ProvidersSpecialist
No1744R1102XOther Service ProvidersSpecialistResearch Study
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine