MEDICARE: CARLOS GIOVANNI CARDENAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	4649	CA

General Provider Information

NPI Number	:	1285432682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS GIOVANNI CARDENAS

Provider Business Mailing Address
First Line	:	9711 HOLLAND ST STE 2
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93312-2773
Country	:	US
Telephone Number	:	661-316-8892
Fax Number	:

Provider Business Practice Location Address
First Line	:	9711 HOLLAND ST STE 2
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93312-2773
Country	:	US
Telephone Number	:	661-316-8892
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2025
Last Update Date	:	03/03/2025

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Directions to “ CARLOS GIOVANNI CARDENAS ” Practice Location

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