Provider Demographics
NPI:1902958549
Name:TEICHERT, CYNTHIA HOLMES (MFT)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:HOLMES
Last Name:TEICHERT
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 1:264 SUNNYBRAE DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-5842
Mailing Address - Country:US
Mailing Address - Phone:925-228-8656
Mailing Address - Fax:925-370-2276
Practice Address - Street 1:957 MOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3729
Practice Address - Country:US
Practice Address - Phone:925-228-8656
Practice Address - Fax:925-370-2276
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAML17132106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist