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General NPI Number Information
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NPI Number | 1639214307
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Entity Type | Individual
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Provider Name | CYNTHIA THOELE LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 03/08/2025
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Provider Practice Location Address
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Address Line | 1460 E HOLT AVE SUITE 166
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City | POMONA
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State | CA
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Zip | 91767-5856
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Country | US
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Telephone | 760-244-4411
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Fax |
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Provider Business Mailing Address
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Address Line | 1512 W RAMONA RD
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City | ALHAMBRA
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State | CA
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Zip | 91803-3934
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Country | US
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Telephone | 760-244-4411
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW79291
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License Number State | CA
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