Provider Demographics
NPI:1124390927
Name:CARDONA, CHERYL R
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:R
Last Name:CARDONA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:R
Other - Last Name:CARDONA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:45713 21ST ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-8360
Mailing Address - Country:US
Mailing Address - Phone:213-215-7833
Mailing Address - Fax:
Practice Address - Street 1:45713 21ST ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-8360
Practice Address - Country:US
Practice Address - Phone:213-215-7833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist