Healthcare Provider Details

I. General information

NPI: 1851237952
Provider Name (Legal Business Name): MS. CYNTHIA BROCKMAN-COLEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3619 W SCRIBNER LN
INGLEWOOD CA
90305-1868
US

IV. Provider business mailing address

3619 W SCRIBNER LN
INGLEWOOD CA
90305-1868
US

V. Phone/Fax

Practice location:
  • Phone: 424-234-8241
  • Fax:
Mailing address:
  • Phone: 424-234-8241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number40966
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: