Provider Demographics
NPI:1154281400
Name:CARMONA-WAYMAN, CASSANDRA ITZEL
Entity type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:ITZEL
Last Name:CARMONA-WAYMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CASSANDRA
Other - Middle Name:ITZEL
Other - Last Name:CARMONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5735 3/4 TEMPLE CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-2510
Mailing Address - Country:US
Mailing Address - Phone:626-679-0541
Mailing Address - Fax:
Practice Address - Street 1:12631 IMPERIAL HWY STE B103
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-6732
Practice Address - Country:US
Practice Address - Phone:213-691-2522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker