Provider Demographics
NPI:1467861252
Name:CARDOZA, MARLA FRANCINE (MS)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:FRANCINE
Last Name:CARDOZA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:MARLA
Other - Middle Name:FRANCINE
Other - Last Name:NAVONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:415 LASSEN DR
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-2611
Mailing Address - Country:US
Mailing Address - Phone:209-507-6965
Mailing Address - Fax:
Practice Address - Street 1:415 LASSEN DR
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-2611
Practice Address - Country:US
Practice Address - Phone:209-507-6965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT127583390200000X
CA87554106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program