Healthcare Provider Details

I. General information

NPI: 1891917126
Provider Name (Legal Business Name): CYNTHIA SAKAMOTO ANDERSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 02/04/2020
Certification Date: 02/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23141 MOULTON PKWY STE 204
LAGUNA HILLS CA
92653-1204
US

IV. Provider business mailing address

23141 MOULTON PKWY STE 204
LAGUNA HILLS CA
92653-1204
US

V. Phone/Fax

Practice location:
  • Phone: 949-516-0606
  • Fax: 949-516-9696
Mailing address:
  • Phone: 949-516-0606
  • Fax: 949-516-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number606541
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: