Healthcare Provider Details

I. General information

NPI: 1013144716
Provider Name (Legal Business Name): CYNTHIA MARIA BAYLON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CYNTHIA MARIA BAYON

II. Dates (important events)

Enumeration Date: 06/19/2009
Last Update Date: 06/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N SAN ANTONIO RD
SANTA BARBARA CA
93110-1316
US

IV. Provider business mailing address

212 S FIRST PL
LOMPOC CA
93436-7332
US

V. Phone/Fax

Practice location:
  • Phone: 805-681-5220
  • Fax:
Mailing address:
  • Phone: 805-698-6660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: