Healthcare Provider Details

I. General information

NPI: 1639105562
Provider Name (Legal Business Name): CYNTHIA FENG RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MUIR RD
MARTINEZ CA
94553-4668
US

IV. Provider business mailing address

975 MAYPORT DR
PITTSBURG CA
94565-4494
US

V. Phone/Fax

Practice location:
  • Phone: 925-372-2131
  • Fax:
Mailing address:
  • Phone: 925-473-9928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number574140
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: