Provider Demographics
NPI:1255762555
Name:CARDOZA DE SALAZAR, GUADALUPE DEL CARMEN
Entity type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:DEL CARMEN
Last Name:CARDOZA DE SALAZAR
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 1:9716 E AVENUE S8
Mailing Address - Street 2:
Mailing Address - City:LITTLEROCK
Mailing Address - State:CA
Mailing Address - Zip Code:93543-1901
Mailing Address - Country:US
Mailing Address - Phone:661-944-0074
Mailing Address - Fax:
Practice Address - Street 1:1543 E PALMDALE BLVD
Practice Address - Street 2:STE P
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-2000
Practice Address - Country:US
Practice Address - Phone:661-947-9554
Practice Address - Fax:661-947-9337
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst