Healthcare Provider Details

I. General information

NPI: 1992689988
Provider Name (Legal Business Name): CECILIA CARDENAS REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W TEMPLE ST
LOS ANGELES CA
90012-2713
US

IV. Provider business mailing address

500 W TEMPLE ST
LOS ANGELES CA
90012-2713
US

V. Phone/Fax

Practice location:
  • Phone: 213-974-2406
  • Fax:
Mailing address:
  • Phone: 213-974-2406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number95231844
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: