MEDICARE: BRENDA CRISTINA CERVANTES

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	1041C0700X	Clinical Social Worker	108284	TX
2	1041C0700X	Clinical Social Worker	29315	CA

General Provider Information

NPI Number	:	1689992695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA CRISTINA CERVANTES

Provider Business Mailing Address
First Line	:	14703 OZARK SITE WAY
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-5697
Country	:	US
Telephone Number	:	281-723-3116
Fax Number	:

Provider Business Practice Location Address
First Line	:	24359 WALNUT ST
Second Line	:
City	:	NEWHALL
State	:	CA
Zip	:	91321-6100
Country	:	US
Telephone Number	:	661-347-2507
Fax Number	:

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

Provider Enumeration Date	:	05/14/2010
Last Update Date	:	03/13/2026

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Directions to “ BRENDA CRISTINA CERVANTES ” Practice Location

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