Healthcare Provider Details

I. General information

NPI: 1154111326
Provider Name (Legal Business Name): MR. GERARDO ANDRES CARDENAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PASADENA HILL-50 NORTH HILL AVE SUITE 100
PASADENA CA
91106
US

IV. Provider business mailing address

50 N HILL AVE STE 100
PASADENA CA
91106-1949
US

V. Phone/Fax

Practice location:
  • Phone: 949-886-3392
  • Fax:
Mailing address:
  • Phone: 619-600-9827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberF5619612
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: