Healthcare Provider Details

I. General information

NPI: 1194409086
Provider Name (Legal Business Name): YESENIA SALAZAR CARDENAS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 DIAMOND BLVD # C100
CONCORD CA
94520-5737
US

IV. Provider business mailing address

2001 DIAMOND BLVD # C100
CONCORD CA
94520-5737
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6331
  • Fax:
Mailing address:
  • Phone: 888-663-6331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number23372
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number23372
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: