| Doctor Name: | MS. CYNTHIA MICHELLE GANANIAN-JACKSON |
| NPI Number: | 1891069084 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN 309244 |
| Business Practice Address: | 3166 Lakeview Dr. Nice, CA - 95464 |
| Business Phone Number: | 7072748955 |
| Business Fax Number: | 7072746791 |
| Mailing Address: | Po Box 533, NICE |
| State: | CA |
| Postal Code: | 954640533 |
| Phone Number: | 7072748955 |
| Fax Number: | 7072746791 |
| NPI Enumeration Date: | 03/06/2012 |
| NPI Last Update Date: | 03/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | RN 309244 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |