Healthcare Provider Details

I. General information

NPI: 1437079837
Provider Name (Legal Business Name): CYNTHIA D LIVINGOOD LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30605 BRIGGS RD
MENIFEE CA
92584-9594
US

IV. Provider business mailing address

514 AMERICAS WAY # 19276
BOX ELDER SD
57719-7600
US

V. Phone/Fax

Practice location:
  • Phone: 910-508-6292
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLMT-LMT-LIC-32020
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: