Provider Demographics
NPI:1639064520
Name:JOVA PADRON, CARLOS OSCAR
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:OSCAR
Last Name:JOVA PADRON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 E MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-5733
Mailing Address - Country:US
Mailing Address - Phone:208-704-2288
Mailing Address - Fax:
Practice Address - Street 1:300 N ARGONNE RD STE 204
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2839
Practice Address - Country:US
Practice Address - Phone:208-699-2595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst