Provider Demographics
NPI:1861121105
Name:DE LEON, CINDY
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:DE LEON
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 1:12810 HEACOCK ST STE B202
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-2873
Mailing Address - Country:US
Mailing Address - Phone:951-247-6542
Mailing Address - Fax:951-247-6959
Practice Address - Street 1:464 S PALM AVE STE C
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4808
Practice Address - Country:US
Practice Address - Phone:951-247-6542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist