Basic Information
| Provider Information | |||||||||
| NPI: | 1003953886 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JAUREGUI | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | JEANEEN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MFT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GUTIERREZ PREECE | ||||||||
| OtherFirstName: | CINDY | ||||||||
| OtherMiddleName: | JEANEEN | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 270 E DOUGLAS AVE | ||||||||
| Address2: | SUITE 110 E | ||||||||
| City: | EL CAJON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920204514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192616481 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5454 EL CAJON BLVD | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921153621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195152400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 46152 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.