Basic Information
| Provider Information | |||||||||
| NPI: | 1639105562 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FENG | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 975 MAYPORT DR | ||||||||
| Address2: | |||||||||
| City: | PITTSBURG | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945654494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9254739928 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 150 MUIR RD | ||||||||
| Address2: | |||||||||
| City: | MARTINEZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945534668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9253722131 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 163WH0200X | 574140 | CA | Y | Nursing Service Providers | Registered Nurse | Home Health |
No ID Information.