Provider Demographics
NPI:1275347072
Name:CARDELLINO, JAMES PAUL
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PAUL
Last Name:CARDELLINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 LAWRENCE EXPY # 389
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-4014
Mailing Address - Country:US
Mailing Address - Phone:408-458-0713
Mailing Address - Fax:
Practice Address - Street 1:530 LAWRENCE EXPY # 389
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4014
Practice Address - Country:US
Practice Address - Phone:408-458-0713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY33878103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist