Healthcare Provider Details

I. General information

NPI: 1629296959
Provider Name (Legal Business Name): CYNTHIA GAYLE NEAL P.P.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 FARNEL RD STE A
SANTA MARIA CA
93458-4960
US

IV. Provider business mailing address

757 DUNTOV DR
ARROYO GRANDE CA
93420-5976
US

V. Phone/Fax

Practice location:
  • Phone: 805-922-0334
  • Fax:
Mailing address:
  • Phone: 805-489-5957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: