Healthcare Provider Details

I. General information

NPI: 1144835950
Provider Name (Legal Business Name): CYNTHIA VAZQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2020
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 PAJARO ST STE B
SALINAS CA
93901-3400
US

IV. Provider business mailing address

339 PAJARO ST STE B
SALINAS CA
93901-3400
US

V. Phone/Fax

Practice location:
  • Phone: 831-800-7530
  • Fax:
Mailing address:
  • Phone: 831-800-7530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number701550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: