Provider Demographics
NPI:1487885612
Name:HANNAN, CYNTHIA E (LMFT)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:E
Last Name:HANNAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 SAN ANTONIO RD
Mailing Address - Street 2:STE. 10
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4632
Mailing Address - Country:US
Mailing Address - Phone:650-493-8655
Mailing Address - Fax:
Practice Address - Street 1:744 SAN ANTONIO RD
Practice Address - Street 2:STE. 10
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4632
Practice Address - Country:US
Practice Address - Phone:650-493-8655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47441106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist