Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND-403 | CA |
NPI | 1063735017 |
---|---|
Provider Name | Cynthia Preston |
First Address | Costa Mesa, CA 92627-2839 |
Second Address | Costa Mesa, CA 92627-2839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2010 |
Last Update Date | 04/03/2010 |