Healthcare Provider Details

I. General information

NPI: 1104021385
Provider Name (Legal Business Name): CYNTHIA J ADAMS MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA J HARRIS

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44444 20TH ST W
LANCASTER CA
93534-2714
US

IV. Provider business mailing address

PO BOX 3136
CANYON COUNTRY CA
91386-3136
US

V. Phone/Fax

Practice location:
  • Phone: 661-951-0070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number34480
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: