Provider Demographics
NPI:1811277239
Name:CARDOSO, JAMIE DIANE
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:DIANE
Last Name:CARDOSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:DIANE
Other - Last Name:GIANNOTTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT, ATR-BC
Mailing Address - Street 1:1885 THE ALAMEDA STE 100H
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1744
Mailing Address - Country:US
Mailing Address - Phone:408-596-3321
Mailing Address - Fax:
Practice Address - Street 1:1885 THE ALAMEDA STE 100H
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1744
Practice Address - Country:US
Practice Address - Phone:408-596-3321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health