Provider Demographics
NPI:1346827607
Name:CARDIFF, SYDNEY
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:CARDIFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:
Other - Last Name:BURGESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:833 ASPEN PEAK LOOP
Mailing Address - Street 2:#325
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011
Mailing Address - Country:US
Mailing Address - Phone:928-279-2231
Mailing Address - Fax:
Practice Address - Street 1:1707 VILLAGE CENTER CIR STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-0577
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
NVLBA0811103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician