Individual
CYNTHIA MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1608
(619) 564-8765
(619) 564-8786
Mailing address
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1608
(619) 564-8765
(619) 564-8786
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY21188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FHC18880F
MEDI
CA
Enumeration date
11/30/2006
Last updated
02/05/2019
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