Basic Information
| Provider Information | |||||||||
| NPI: | 1407002199 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PADILLA | ||||||||
| FirstName: | CINDY | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 39959 SIERRA HWY | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | PALMDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935503313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612234201 | ||||||||
| FaxNumber: | 6612739357 | ||||||||
| Practice Location | |||||||||
| Address1: | 39959 SIERRA HWY | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | PALMDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935503313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612234201 | ||||||||
| FaxNumber: | 6612739357 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2008 | ||||||||
| LastUpdateDate: | 03/18/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | ASW25190 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.