Provider Demographics
NPI:1639406077
Name:SIMS, CYNTHIA EILEEN
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:EILEEN
Last Name:SIMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6356 TABERNACLE LN
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-3437
Mailing Address - Country:US
Mailing Address - Phone:760-985-1408
Mailing Address - Fax:
Practice Address - Street 1:6356 TABERNACLE LN
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-3437
Practice Address - Country:US
Practice Address - Phone:760-985-1408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA760300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse