Provider Demographics
NPI:1932425592
Name:ELLINGTON, CINDY SHINWON (MFT)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:SHINWON
Last Name:ELLINGTON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 W ORANGEWOOD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2041
Mailing Address - Country:US
Mailing Address - Phone:714-515-2556
Mailing Address - Fax:714-939-7720
Practice Address - Street 1:1745 W ORANGEWOOD AVE STE 101
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2041
Practice Address - Country:US
Practice Address - Phone:714-515-2556
Practice Address - Fax:714-939-7720
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT - 372106H00000X
CAMFC39943106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist