Provider Demographics
NPI:1164936811
Name:RODRIGUEZ CARDONA, JAVIER FERNANDO (PHD CLINICAL PSYCHOL)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:FERNANDO
Last Name:RODRIGUEZ CARDONA
Suffix:
Gender:M
Credentials:PHD CLINICAL PSYCHOL
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Mailing Address - Street 1:2701 S 77 SUNSHINESTRIP # O5Q
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8318
Mailing Address - Country:US
Mailing Address - Phone:956-430-9355
Mailing Address - Fax:
Practice Address - Street 1:2701 S 77 SUNSHINESTRIP # O5Q
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8318
Practice Address - Country:US
Practice Address - Phone:956-430-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR5985103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical