Provider Demographics
NPI:1598225526
Name:CARDOSO MORENO, ALEXIA
Entity Type:Individual
Prefix:
First Name:ALEXIA
Middle Name:
Last Name:CARDOSO MORENO
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 1:916 ACOSTA PLZ UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-1383
Mailing Address - Country:US
Mailing Address - Phone:831-585-8832
Mailing Address - Fax:
Practice Address - Street 1:9010 SOQUEL DR
Practice Address - Street 2:
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-4082
Practice Address - Country:US
Practice Address - Phone:831-684-2166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician