Healthcare Provider Details

I. General information

NPI: 1326329665
Provider Name (Legal Business Name): MS. CYNTHIA LUJAN DELEON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2011
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11046 MAIN ST
EL MONTE CA
91731-2617
US

IV. Provider business mailing address

11046 MAIN ST
EL MONTE CA
91731-2617
US

V. Phone/Fax

Practice location:
  • Phone: 626-636-2370
  • Fax:
Mailing address:
  • Phone: 626-453-3412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: