MEDICARE: CINDY JOHN PH.D.

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	103TC2200X	Clinical Child & Adolescent Psychologist	PSY25091	CA

General Provider Information

NPI Number	:	1598960148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY JOHN PH.D.

Provider Business Mailing Address
First Line	:	2123 S EL CAMINO REAL STE A
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6275
Country	:	US
Telephone Number	:	909-528-1040
Fax Number	:

Provider Business Practice Location Address
First Line	:	27281 LAS RAMBLAS STE 200
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-8303
Country	:	US
Telephone Number	:	714-202-7275
Fax Number	:

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

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	03/13/2026

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