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General NPI Number Information
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NPI Number | 1598996613
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Entity Type | Individual
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Provider Name | CYNTHIA JANET CORDOVA MSW
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Gender | Female
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 12001 W WASHINGTON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90066-5801
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Country | US
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Telephone | 833-574-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 6127 BEAR AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-4601
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Country | US
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Telephone | 323-773-7471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | ASW67714
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCSW99325
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW67714
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW99325
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License Number State | CA
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