Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003046640 |
---|---|
Provider Name | Dr. Randy Cima |
First Address | Riverside, CA 92509-1503 |
Second Address | Riverside, CA 92503-3507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2009 |
Last Update Date | 16/07/2009 |