Healthcare Provider Details

I. General information

NPI: 1962313791
Provider Name (Legal Business Name): STEPHANIE CARDENAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

631 MAPLE CT
SANTA MARIA CA
93454-7649
US

IV. Provider business mailing address

631 MAPLE CT
SANTA MARIA CA
93454-7649
US

V. Phone/Fax

Practice location:
  • Phone: 805-865-2940
  • Fax:
Mailing address:
  • Phone: 805-865-2940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberKK498650
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberKK498650
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberKK498650
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License NumberKK498650
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberKK498650
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License NumberKK498650
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberKK498650
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code347D00000X
TaxonomyTrain
License NumberKK498650
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License NumberKK498650
License Number StateCA
# 10
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberKK498650
License Number StateCA
# 11
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberKK498650
License Number StateCA
# 12
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberKK498650
License Number StateCA
# 13
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License NumberKK498650
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: