Provider Demographics
NPI:1689404808
Name:GRANCOURT, CYNTHIA MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:MARIE
Last Name:GRANCOURT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4042 PRIMAVERA RD UNIT 10
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-4046
Mailing Address - Country:US
Mailing Address - Phone:805-708-3644
Mailing Address - Fax:
Practice Address - Street 1:4042 PRIMAVERA RD UNIT 10
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-4046
Practice Address - Country:US
Practice Address - Phone:805-708-3644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY34851103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical