Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY19658 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY19658 | CA |
NPI | 1003325143 |
---|---|
Provider Name | Dr. Cynthia Michelle Telander |
First Address | Woodbridge, CA 95258-9290 |
Second Address | Woodbridge, CA 95258-9290 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2017 |
Last Update Date | 20/09/2017 |