Provider Demographics
NPI:1649605742
Name:KARDEL, CECILIA S (LMFT)
Entity type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:S
Last Name:KARDEL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4171 PIEDMONT AVE STE 206B
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5175
Mailing Address - Country:US
Mailing Address - Phone:917-319-4497
Mailing Address - Fax:
Practice Address - Street 1:4153 PIEDMONT AVE APT 2
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5108
Practice Address - Country:US
Practice Address - Phone:917-319-4497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-08
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106482106H00000X
CA86575101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist