Basic Information
Provider Information
NPI: 1437403334
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALFORD
FirstName: CYNTHIA
MiddleName: D.
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10470 OLD PLACERVILLE RD
Address2: SUITE 100
City: SACRAMENTO
State: CA
PostalCode: 958272539
CountryCode: US
TelephoneNumber: 8004700071
FaxNumber:  
Practice Location
Address1: 1625 STOCKTON BLVD
Address2: SUITE 104
City: SACRAMENTO
State: CA
PostalCode: 958167097
CountryCode: US
TelephoneNumber: 9164546667
FaxNumber: 9164546796
Other Information
ProviderEnumerationDate: 10/31/2012
LastUpdateDate: 10/31/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XLCS26284CAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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