Healthcare Provider Details

I. General information

NPI: 1194471300
Provider Name (Legal Business Name): CINDY ESTEFANY BEJARANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 FASHION ISLAND BLVD STE 310
SAN MATEO CA
94404-1587
US

IV. Provider business mailing address

265 SAN ANSELMO AVE N APT 4
SAN BRUNO CA
94066-4955
US

V. Phone/Fax

Practice location:
  • Phone: 415-265-7213
  • Fax:
Mailing address:
  • Phone: 650-392-5423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: