Healthcare Provider Details

I. General information

NPI: 1194632745
Provider Name (Legal Business Name): CYNTHIA BILLINGSLEA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 OPAL WAY
GARDENA CA
90247-2589
US

IV. Provider business mailing address

PO BOX 451272
LOS ANGELES CA
90045-8513
US

V. Phone/Fax

Practice location:
  • Phone: 310-428-3950
  • Fax:
Mailing address:
  • Phone: 310-428-3950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: