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NPI Code Detail

MEDICARE: MS. CYNTHIA JOYCE ESTAVILLO LOPEZ MSC, MFCT

MEDICARE: MS. CYNTHIA JOYCE ESTAVILLO LOPEZ MSC, MFCT
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
1106H00000XMarriage & Family Therapist112475CA

General Provider Information

NPI Number : 1609911650
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CYNTHIA JOYCE ESTAVILLO LOPEZ MSC, MFCT
Provider Business Mailing Address
First Line : 3840 ROSIN CT STE 100
Second Line :
City : SACRAMENTO
State : CA
Zip : 95834-1645
Country : US
Telephone Number : 916-956-6747
Fax Number : 916-429-7824
Provider Business Practice Location Address
First Line : 3840 ROSIN CT STE 100
Second Line :
City : SACRAMENTO
State : CA
Zip : 95834-1645
Country : US
Telephone Number : 916-956-6747
Fax Number : 916-429-7824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 02/23/2024

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Directions to “ MS. CYNTHIA JOYCE ESTAVILLO LOPEZ MSC, MFCT” Practice Location

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