Healthcare Provider Details

I. General information

NPI: 1336532365
Provider Name (Legal Business Name): CINDY HERRERA LMFT 105007
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2015
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 MARTINVALE LN
SAN JOSE CA
95119-1319
US

IV. Provider business mailing address

185 MARTINVALE LN
SAN JOSE CA
95119-1319
US

V. Phone/Fax

Practice location:
  • Phone: 408-207-0070
  • Fax: 408-642-6052
Mailing address:
  • Phone: 408-284-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number105007
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: