Provider Demographics
NPI:1730581430
Name:URENA, CYNTHIA (NP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:URENA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 KNOLL DR
Mailing Address - Street 2:SUITE 219
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7307
Mailing Address - Country:US
Mailing Address - Phone:805-677-5312
Mailing Address - Fax:805-523-2233
Practice Address - Street 1:612 SPRING RD
Practice Address - Street 2:BLDG. A
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-1298
Practice Address - Country:US
Practice Address - Phone:805-523-5400
Practice Address - Fax:805-523-2233
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP95001162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily