Cynthia Ann Cutshall, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

21217 Issued in CA

Practice address

1928 Saint Marys Rd
Moraga, CA 94556-2715

Phone

(925) 631-4364

NPI assigned

Feb 15, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2021 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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  NPD (past)
• Asana Integrated Medical Group PC

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  • Sioux Falls, SD
  • NPI 1396783379

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1184767394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1928 SAINT MARYS RD",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945562715",
            "telephone_number": "925-631-4364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 SAINT MARYS RD",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945562715",
            "telephone_number": "925-631-4364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUTSHALL",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "21217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Cheung, D.D.S.
• Forrest J Cioppa, MD
• Charles Cobb, OTR
• Alexandra Coleman, M.S.,CCC-SLP
• Mary Ann Crahan, FNP
• Elena Davydova, LLMSW
• Divine Health Inc
• Justine Dolan, MS, CCC-SLP
• Niva Dotan
• Sally Elton, ATC

• Clinical Psychologist in Moraga, CA
• Providers in Moraga, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.