Provider Demographics
NPI:1336030030
Name:CARDENAS, TADRIA
Entity type:Individual
Prefix:
First Name:TADRIA
Middle Name:
Last Name:CARDENAS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5836 HESPER WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-0207
Mailing Address - Country:US
Mailing Address - Phone:909-361-1550
Mailing Address - Fax:
Practice Address - Street 1:10824 OLSON DR STE C
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-5651
Practice Address - Country:US
Practice Address - Phone:916-847-5008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst