Healthcare Provider Details

I. General information

NPI: 1215867676
Provider Name (Legal Business Name): CYNTHIA VERONICA DUFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18058 VALLADARES DR
SAN DIEGO CA
92127-1131
US

IV. Provider business mailing address

18580 CAMINITO PASADERO
SAN DIEGO CA
92128-1062
US

V. Phone/Fax

Practice location:
  • Phone: 858-335-3194
  • Fax:
Mailing address:
  • Phone: 858-335-3194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number160570
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: