Provider Demographics
NPI:1477959377
Name:CARDENAS, CLAUDIA ELIZABETH
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ELIZABETH
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 W 6TH ST STE 212C
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-1642
Mailing Address - Country:US
Mailing Address - Phone:888-662-9378
Mailing Address - Fax:888-402-2304
Practice Address - Street 1:1307 W 6TH ST STE 212C
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-1642
Practice Address - Country:US
Practice Address - Phone:888-662-9378
Practice Address - Fax:888-402-2304
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF83047101YM0800X
101YM0800X
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health