MEDICARE: CYNTHIA IRIS HYMOWITZ STEPHENS

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	101YM0800X	Mental Health Counselor	MFT 31999	CA

General Provider Information

NPI Number	:	1619120177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA IRIS HYMOWITZ STEPHENS

Provider Business Mailing Address
First Line	:	1132 ORCHARD ST
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95404-3341
Country	:	US
Telephone Number	:	707-280-1194
Fax Number	:

Provider Business Practice Location Address
First Line	:	1023 4TH ST
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95404-4301
Country	:	US
Telephone Number	:	707-280-1194
Fax Number	:

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

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	05/13/2026

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