Healthcare Provider Details

I. General information

NPI: 1245279983
Provider Name (Legal Business Name): MATTHEW CORDOVA PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MUIR RD # 116
MARTINEZ CA
94553-4668
US

IV. Provider business mailing address

1908 HILLCREST AVE
ANTIOCH CA
94509-2817
US

V. Phone/Fax

Practice location:
  • Phone: 925-372-2521
  • Fax:
Mailing address:
  • Phone: 650-759-6939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY17511
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: