Individual provider Active NPI

Cynthia Ann Borges-O'Dell, LMFT

  • Marriage & Family Therapist
  • Modesto, CA
National Provider Identifier
1639208499
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 37817 Issued in CA
Practice address
615 13TH St
Suite B
Modesto, CA 95354-2435
Phone
(209) 602-2098
Fax
(209) 579-0605
NPI assigned
Mar 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 37817 CA Primary

Addresses

Primary practice location

615 13TH St
Suite B
Modesto, CA 95354-2435

Mailing address

615 13TH St
Suite B
Modesto, CA 95354-2435
Phone (209) 602-2098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240521000484 CA Practitioner - Marriage and Family Therapist 8325480593 Practice locations: Modesto, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

615 13TH St
Suite B
Modesto, CA 95354-2456
Phone (209) 602-2098

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC 37817CAMDMarriage & Family Therapist
37817CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639208499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 13TH ST",
            "address_2": "SUITE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953542435",
            "telephone_number": "209-602-2098",
            "fax_number": "209-579-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 13TH ST",
            "address_2": "SUITE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953542435",
            "telephone_number": "209-602-2098",
            "fax_number": "209-579-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGES-O'DELL",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 37817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.