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General NPI Number Information
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NPI Number | 1043642341
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Entity Type | Individual
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Provider Name | VICTOR CORDOVA PSY.D
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Gender | Male
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 9033 BASE LINE RD STE A
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-1214
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Country | US
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Telephone | 909-922-2442
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Fax | 909-999-2377
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Provider Business Mailing Address
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Address Line | 9033 BASE LINE RD STE A
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-1214
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Country | US
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Telephone | 909-922-2442
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Fax | 909-999-2377
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY29001
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License Number State | CA
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