Healthcare Provider Details

I. General information

NPI: 1083308845
Provider Name (Legal Business Name): CYNTHIA AYORINDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 N TUSTIN AVE STE 225
SANTA ANA CA
92705-8688
US

IV. Provider business mailing address

1401 N TUSTIN AVE STE 225
SANTA ANA CA
92705-8688
US

V. Phone/Fax

Practice location:
  • Phone: 714-221-6400
  • Fax: 714-221-6401
Mailing address:
  • Phone: 714-221-6400
  • Fax: 714-221-6401

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: