Healthcare Provider Details

I. General information

NPI: 1780877845
Provider Name (Legal Business Name): CYNTHIA RESENDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 GOUGH ST
SAN FRANCISCO CA
94109-7622
US

IV. Provider business mailing address

1010 GOUGH ST
SAN FRANCISCO CA
94109-7622
US

V. Phone/Fax

Practice location:
  • Phone: 415-474-7310
  • Fax:
Mailing address:
  • Phone: 415-474-7310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberA84098
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: