Healthcare Provider Details

I. General information

NPI: 1902366172
Provider Name (Legal Business Name): CYNTHIA M SCHAPIRO CCLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 03/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 SAN JOSE ST
SALINAS CA
93901-3901
US

IV. Provider business mailing address

137 SURFSIDE AVE
SANTA CRUZ CA
95060-5329
US

V. Phone/Fax

Practice location:
  • Phone: 800-214-5439
  • Fax:
Mailing address:
  • Phone: 831-239-6840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number4914
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: