Provider Demographics
NPI:1184250383
Name:CADENAS, JHAJAIRA ELIZABETH
Entity type:Individual
Prefix:
First Name:JHAJAIRA
Middle Name:ELIZABETH
Last Name:CADENAS
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 1:4215 W ASTER DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-1935
Mailing Address - Country:US
Mailing Address - Phone:480-432-8293
Mailing Address - Fax:
Practice Address - Street 1:11725 N 19TH AVE STE 8
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-3500
Practice Address - Country:US
Practice Address - Phone:480-432-8293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA160141610139152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D11302884OtherIDENTIFICATION CARD ARIZONA