Healthcare Provider Details
I. General information
NPI: 1538502406
Provider Name (Legal Business Name): CYNARA CONROY ALLISON MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/10/2013
Last Update Date: 12/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1716 MANHATTAN BEACH BLVD. #C
MANHATTAN BEACH CA
90266
US
IV. Provider business mailing address
1466 MANHATTAN BEACH BLVD. #4
MANHATTAN BEACH CA
90266
US
V. Phone/Fax
- Phone: 310-406-8817
- Fax:
- Phone: 310-406-8817
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | MFT18153 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: