Provider Demographics
NPI:1598294639
Name:CARDINOZA, KIMBERLY C (BCCBA)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:C
Last Name:CARDINOZA
Suffix:
Gender:F
Credentials:BCCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1159 STOCKTON PL
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3238
Mailing Address - Country:US
Mailing Address - Phone:909-635-1975
Mailing Address - Fax:
Practice Address - Street 1:1159 STOCKTON PL
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-3238
Practice Address - Country:US
Practice Address - Phone:909-635-1975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ01-15-20625103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst