Healthcare Provider Details

I. General information

NPI: 1962316448
Provider Name (Legal Business Name): ESMERALDA FRANCINE CARDOSO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18062 LAUREL DR
FONTANA CA
92336-2826
US

IV. Provider business mailing address

18062 LAUREL DR
FONTANA CA
92336-2826
US

V. Phone/Fax

Practice location:
  • Phone: 909-678-0682
  • Fax:
Mailing address:
  • Phone: 909-678-0682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: