Provider Demographics
NPI:1144645094
Name:BUTLER, CINDY (APRN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16466 BERNARDO CENTER DR STE 188
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2522
Mailing Address - Country:US
Mailing Address - Phone:858-504-2308
Mailing Address - Fax:
Practice Address - Street 1:16466 BERNARDO CENTER DR STE 188
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2522
Practice Address - Country:US
Practice Address - Phone:858-504-2308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-03
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60454172363LP0808X
CA95020184363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health