Provider Demographics
NPI:1467058446
Name:CARDENAS, JESSICA ELIZABETH (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ELIZABETH
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
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Mailing Address - Street 1:20422 SIR PENGUIN DR
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447-2014
Mailing Address - Country:US
Mailing Address - Phone:281-904-5557
Mailing Address - Fax:281-904-5557
Practice Address - Street 1:20422 SIR PENGUIN DR
Practice Address - Street 2:
Practice Address - City:HOCKLEY
Practice Address - State:TX
Practice Address - Zip Code:77447-2014
Practice Address - Country:US
Practice Address - Phone:281-904-5557
Practice Address - Fax:281-904-5557
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician