Healthcare Provider Details

I. General information

NPI: 1730008582
Provider Name (Legal Business Name): CYNTHIA LUGO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5377 N FRESNO ST
FRESNO CA
93710-6874
US

IV. Provider business mailing address

4729 E FEDORA AVE
FRESNO CA
93726-6409
US

V. Phone/Fax

Practice location:
  • Phone: 888-880-9270
  • Fax:
Mailing address:
  • Phone: 559-916-6851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberF2017813
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: