Healthcare Provider Details

I. General information

NPI: 1467479824
Provider Name (Legal Business Name): CYNTHIA BANKS C.N.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 03/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3028 73RD AVE
OAKLAND CA
94605-2541
US

IV. Provider business mailing address

3028 73RD AVE
OAKLAND CA
94605-2541
US

V. Phone/Fax

Practice location:
  • Phone: 415-794-9031
  • Fax: 510-373-6446
Mailing address:
  • Phone: 415-794-9031
  • Fax: 510-373-6446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNMW1497
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: