Provider Demographics
NPI:1255178968
Name:CEDENO, MAGDIEL SR (RBT)
Entity type:Individual
Prefix:
First Name:MAGDIEL
Middle Name:
Last Name:CEDENO
Suffix:SR
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14170 BLIND BANDIT CRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-4692
Mailing Address - Country:US
Mailing Address - Phone:818-521-5648
Mailing Address - Fax:
Practice Address - Street 1:119 SW LOOP 410
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-2101
Practice Address - Country:US
Practice Address - Phone:210-745-2753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician