Provider Demographics
NPI:1447492343
Name:ALLEN, CYNTHIA KAREN (MFT)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:KAREN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 AVENIDA SALVADOR
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-3240
Mailing Address - Country:US
Mailing Address - Phone:949-584-4777
Mailing Address - Fax:949-361-4778
Practice Address - Street 1:2235 AVENIDA SALVADOR
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-3240
Practice Address - Country:US
Practice Address - Phone:949-584-4777
Practice Address - Fax:949-361-4778
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT33938101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor