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NPI Code Detail

MEDICARE: CYNTHIA EDITH ANDRADE BS, ATC

MEDICARE:   CYNTHIA EDITH ANDRADE  BS, ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
22255A2300XAthletic Trainer

General Provider Information

NPI Number : 1174044424
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA EDITH ANDRADE BS, ATC
Provider Business Mailing Address
First Line : 1260 S HULBERT AVE
Second Line :
City : FRESNO
State : CA
Zip : 93706-2408
Country : US
Telephone Number : 559-217-3943
Fax Number :
Provider Business Practice Location Address
First Line : 2309 TULARE ST STE 101
Second Line :
City : FRESNO
State : CA
Zip : 93721-2287
Country : US
Telephone Number : 559-457-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2017
Last Update Date : 12/10/2019

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Directions to “ CYNTHIA EDITH ANDRADE BS, ATC” Practice Location

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