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NPI Code Detail

MEDICARE: DAVID CORDOVA

MEDICARE: DAVID CORDOVA
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
1106H00000XMarriage & Family Therapist
2390200000XStudent in an Organized Health Care Education/Training Program
3106H00000XMarriage & Family Therapist100746CA

General Provider Information

NPI Number : 1629437538
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID CORDOVA
Provider Business Mailing Address
First Line : 3301 37TH AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95824-2418
Country : US
Telephone Number : 916-210-8782
Fax Number :
Provider Business Practice Location Address
First Line : 3301 37TH AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95824-2418
Country : US
Telephone Number : 916-210-8782
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2016
Last Update Date : 07/21/2022

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Directions to “ DAVID CORDOVA ” Practice Location

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