Provider Demographics
NPI:1902070154
Name:HURTADO, CYNTHIA R (LCSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:R
Last Name:HURTADO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:R
Other - Last Name:BALANDRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20151 NORDHOFF ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-6215
Mailing Address - Country:US
Mailing Address - Phone:818-407-3179
Mailing Address - Fax:
Practice Address - Street 1:20151 NORDHOFF ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-6215
Practice Address - Country:US
Practice Address - Phone:818-407-3179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X, 225400000X
CA652101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner