Provider Demographics
NPI:1881883379
Name:CEDENO, MARIA LORENA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LORENA
Last Name:CEDENO
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 1:1747 AUTUMN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-3978
Mailing Address - Country:US
Mailing Address - Phone:707-864-0472
Mailing Address - Fax:707-864-0472
Practice Address - Street 1:1747 AUTUMN MEADOW DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-3978
Practice Address - Country:US
Practice Address - Phone:707-864-0472
Practice Address - Fax:707-864-0472
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker