| Cardinal Wellness, Inc. | |
|
15814 Winchester Blvd Ste 105 Los Gatos CA 95030-3333 | |
| (408) 529-7864 | |
| (408) 331-3211 |
| Full Name | Cardinal Wellness, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 15814 Winchester Blvd Ste 105, Los Gatos, California |
| Authorized Official Name and Position | Yolanda Agredano De Moreno (CEO/PSYCHIATRIST) |
| Authorized Official Contact | 4085297864 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cardinal Wellness, Inc. 15814 Winchester Blvd Ste 105 Los Gatos CA 95030-3333 Ph: (408) 529-7864 | Cardinal Wellness, Inc. 15814 Winchester Blvd Ste 105 Los Gatos CA 95030-3333 Ph: (408) 529-7864 |
| NPI Number | 1114284817 |
|---|---|
| Provider Enumeration Date | 04/18/2012 |
| Last Update Date | 11/04/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114284817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A96450 (California) | Secondary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | A96450 (California) | Primary |
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