Healthcare Provider Details

I. General information

NPI: 1285573402
Provider Name (Legal Business Name): CYNTHIA CELESTE TAGLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 E 4TH ST
SANTA ANA CA
92705-3804
US

IV. Provider business mailing address

949 10TH ST
HUNTINGTON BEACH CA
92648-3405
US

V. Phone/Fax

Practice location:
  • Phone: 156-265-9988
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: