Provider Demographics
NPI:1780924621
Name:CARDONA, ISIS
Entity type:Individual
Prefix:
First Name:ISIS
Middle Name:
Last Name:CARDONA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8072
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-8072
Mailing Address - Country:US
Mailing Address - Phone:787-531-8053
Mailing Address - Fax:
Practice Address - Street 1:270 CALLE COLON
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-2937
Practice Address - Country:US
Practice Address - Phone:787-531-8053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2025-06-24
Deactivation Date:2014-12-23
Deactivation Code:
Reactivation Date:2025-06-23
Provider Licenses
StateLicense IDTaxonomies
NYP121148101YM0800X
PR004750103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health