MEDICARE: MS. CYNTHIA KAREN ALLEN MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	MFT33938	CA

General Provider Information

NPI Number	:	1447492343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA KAREN ALLEN MFT

Provider Business Mailing Address
First Line	:	2235 AVENIDA SALVADOR
Second Line	:
City	:	SAN CLEMENTE
State	:	CA
Zip	:	92672-3240
Country	:	US
Telephone Number	:	949-584-4777
Fax Number	:	949-361-4778

Provider Business Practice Location Address
First Line	:	2235 AVENIDA SALVADOR
Second Line	:
City	:	SAN CLEMENTE
State	:	CA
Zip	:	92672-3240
Country	:	US
Telephone Number	:	949-584-4777
Fax Number	:	949-361-4778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2009
Last Update Date	:	03/24/2009

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