Provider Demographics
NPI:1538246244
Name:PAGMANUA, CYNTHIA
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:PAGMANUA
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 1:100 38TH ST
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-2207
Mailing Address - Country:US
Mailing Address - Phone:510-231-1261
Mailing Address - Fax:510-231-8551
Practice Address - Street 1:100 38TH ST
Practice Address - Street 2:SUITE 2400
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94805-2207
Practice Address - Country:US
Practice Address - Phone:510-231-1261
Practice Address - Fax:510-231-8551
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA389382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry