Provider Demographics
NPI:1245079037
Name:CARDENAS, BOBBIE JO XAVIERA (LCSW)
Entity type:Individual
Prefix:
First Name:BOBBIE JO
Middle Name:XAVIERA
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BOBBIE JO
Other - Middle Name:XAVIERA
Other - Last Name:PADILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 BRAZOS ST APT 3105
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-3785
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10161 ALY MAY DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-1408
Practice Address - Country:US
Practice Address - Phone:512-483-1421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX591111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical