Provider Demographics
NPI:1689327223
Name:CORDANO, PAMELA LOUISE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:LOUISE
Last Name:CORDANO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 4TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-4151
Mailing Address - Country:US
Mailing Address - Phone:530-219-7430
Mailing Address - Fax:
Practice Address - Street 1:621 4TH ST STE 1
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4151
Practice Address - Country:US
Practice Address - Phone:530-219-7430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36861106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist