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NPI 1639087042

NPI 1639087042 : CYDNEY ELTISTE PMHNP : ATWOOD, CA

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General NPI Number Information
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    NPI Number           |    1639087042
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    Entity Type          |    Individual 
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    Provider Name        |    CYDNEY ELTISTE PMHNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/28/2026
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    Last Update Date     |    08/28/2026
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Provider Practice Location Address
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    Address Line         |    1679 E ORANGETHORPE AVE 
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    City                 |    ATWOOD
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    State                |    CA
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    Zip                  |    92811-9997
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    Country              |    US
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    Telephone            |    714-524-1709
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1679 E ORANGETHORPE AVE 
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    City                 |    ATWOOD
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    State                |    CA
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    Zip                  |    92811-9997
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    Country              |    US
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    Telephone            |    714-524-1709
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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        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    95041193
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    License Number State |    CA
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