Provider Demographics
NPI:1891429684
Name:CEDRES, DANA MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:MARIE
Last Name:CEDRES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11373 MISSION HILLS TER
Mailing Address - Street 2:
Mailing Address - City:CHOWCHILLA
Mailing Address - State:CA
Mailing Address - Zip Code:93610-8018
Mailing Address - Country:US
Mailing Address - Phone:209-445-0330
Mailing Address - Fax:
Practice Address - Street 1:11373 MISSION HILLS TER
Practice Address - Street 2:
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-8018
Practice Address - Country:US
Practice Address - Phone:209-445-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program