Provider Demographics
NPI:1932572088
Name:CARDALDA, ELSA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELSA
Middle Name:
Last Name:CARDALDA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 CALLE CRUZ APT 3E
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00901-1621
Mailing Address - Country:US
Mailing Address - Phone:787-399-7723
Mailing Address - Fax:
Practice Address - Street 1:301 CALLE RECINTO SUR
Practice Address - Street 2:COND GALLARDO SUITE 606
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901
Practice Address - Country:US
Practice Address - Phone:787-399-7723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1617103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist