DR. ISIDRO ACOSTA CARDENO (NPI# 1689766081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689766081 |
| Entity Type | Individual |
| Full Name | DR. ISIDRO ACOSTA CARDENO |
| Credential | M.D. |
| Practice Address |
300 Prison Rd Represa CA 95671-3001 |
| Mailing Address |
7931 Indian Springs Way Orangevale CA 95662-2154 |
| Practice Telephone | 9169852561 |
| Practice Fax Number | 9163513001 |
| Mailing Telephone | 9167255494 |
| Mailing Fax Number | 9163513001 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | A34909 | CA | Other Service Providers |
| Street Address |
300 PRISON RD |
| City | REPRESA |
| State | CA |
| Zip Code | 95671-3001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255359212 | Sadoutounnissa Meer | Psychiatry & Neurology | 300 Prison Rd, Represa, CA 95671-2295 | 2006-07-18 |
| 1972843142 | Robert Charles Mcmahon | Psychologist | 300 Prison Rd, Folsom State Prison, Represa, CA 95671-3001 | 2013-02-25 |
| 1801136254 | Stephen Joseph Clavere | Psychologist | 300 Prison Rd, Represa, CA 95671-3001 | 2013-02-21 |
| 1447590997 | Meg Eu Cho | Psychologist | 300 Prison Rd, Represa, CA 95671-3001 | 2013-02-20 |
| 1588901938 | Kimberly Loraine Wells | Psychologist | 300 Prison Rd, Represa, CA 95671-3001 | 2013-01-04 |
| 1770842205 | Myoung Soo Kim | Pharmacist | 300 Prison Rd, Represa, CA 95671-3001 | 2012-05-03 |
| 1386902633 | Frank D Harris IIi | Pharmacist | 300 Prison Rd, Folsom State Prison - Pharmacy, Represa, CA 95671-4071 | 2012-04-24 |
| 1023388774 | James Dennis Scott | Psychologist | 300 Prison Rd, Attn: Mental Health, Represa, CA 95671-3001 | 2012-01-11 |
| 1598087967 | Ellie I Johnson | Psychologist | 300 Prison Rd, Represa, CA 95671-0002 | 2010-02-25 |
| 1619128014 | Molly Josslyn Michau | Social Worker | 300 Prison Rd, Represa, CA 95671-3001 | 2008-10-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811207426 | Nicole Calma | Counselor | 100 Prison Road Sacramento State Prison, Represa, CA 95671 | 2010-10-15 |
| 1578737359 | Laura Beebe | Registered Nurse | 1 Prison Road, Csp Sacramento, Folsom, CA 95671 | 2008-04-14 |
| 1588661730 | Gregory Carl Tinloy | Dentist | 100 Prison Rd., Represa, CA 95671 | 2005-07-01 |
| 1174768972 | Timothea Greer Mcginley | Psychologist | 100 Prison Road, Csp Sacramento, Represa, CA 95671 | 2008-12-08 |
| 1275717340 | Harry Moran Singh Dhesi | Dentist | 100 Prison Road, California State Prison Sacramento, Represa, CA 95671 | 2007-12-24 |
| 1235312463 | John Maciel Jr. | Dentist | 100 Prison Road, California State Prison Sacramento, Represa, CA 95671 | 2007-12-11 |
| 1730362930 | Dennis Rulon Fairbourn | Dentist | 100 Prison Road, California State Prison Sacramento, Represa, CA 95671 | 2007-12-11 |
| 1194070219 | Regina White | Social Worker | Csp Sacramento Mhsds Regina White, 100 Prison Road, Represa, CA 95671-0001 | 2012-07-14 |
| 1306174933 | Dudley Atkinson | Social Worker | Csp Sacramento, 100 Prison Road P.o., Represa, CA 95671-0001 | 2009-11-19 |
| 1932344280 | Amy Louise Holliday | Case Manager/Care Coordinator | California State Prison At Sacramento, 100 Prison Rd, Represa, CA 95671-0001 | 2008-12-15 |
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| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730755 | Zaccary Griffin | Military Health Care Provider | Building 4101 Stuart Mesa Rd, Camp Pendleton, CA 92055 | 2020-11-02 |
| 1629692389 | Christopher Matey | Military Health Care Provider | 34800 Bob Wilson Dr Ste 110, San Diego, CA 92134-1110 | 2020-05-29 |
| 1982225769 | Jin Ah Kim | Military Health Care Provider | Naval Medical Center San Diego 38400 Bon Wilson Drive, San Diego, CA 92134-5000 | 2020-05-03 |
| 1124647680 | Katherine Koliadko | Military Health Care Provider | 11023 Evans St, Loma Linda, CA 92354-2708 | 2020-04-14 |
| 1508495201 | Benjamin Michael Taylor | Military Health Care Provider | Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2020-04-04 |
| 1588292858 | Korina Erin Sandoval | Military Health Care Provider | Naval Medical Center Drive 38400 Bob Wilson Dr, San Diego, CA 92134-5000 | 2020-03-31 |
| 1033746508 | Hannah Johnson | Military Health Care Provider | 34800 Bob Wilson Dr Ste 403, San Diego, CA 92134-1403 | 2020-03-25 |
| 1891336541 | Prana Hands Nonprofit | Military Health Care Provider | 2180 Garnet Ave Ste 3l, San Diego, CA 92109-3676 | 2019-10-03 |
| 1578124194 | David M Allen | Military Health Care Provider | 1st Mlg, Bldg 150121, Camp Pendleton, CA 92055 | 2019-06-25 |
| 1992366587 | Darion Pegues | Military Health Care Provider | 3530 Kelsey St, San Diego, CA 92124-3516 | 2019-06-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.