Healthcare Provider Details

I. General information

NPI: 1639209687
Provider Name (Legal Business Name): CINDEE H DAO BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 47TH AVE STE 111
SACRAMENTO CA
95824-3923
US

IV. Provider business mailing address

4709 BRABANT WAY
ELK GROVE CA
95757-3206
US

V. Phone/Fax

Practice location:
  • Phone: 916-393-1222
  • Fax:
Mailing address:
  • Phone: 916-393-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: