Healthcare Provider Details

I. General information

NPI: 1558483636
Provider Name (Legal Business Name): CYREL PABLO LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. CYREL ANN TANGCO

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 BRISTOL ST STE G201
COSTA MESA CA
92626-7914
US

IV. Provider business mailing address

2900 BRISTOL ST STE G201
COSTA MESA CA
92626-7914
US

V. Phone/Fax

Practice location:
  • Phone: 714-280-7663
  • Fax:
Mailing address:
  • Phone: 657-216-6730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number78539
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: