Active NPI
Fernando Cordero, PH.D.
- Clinical Psychologist
- Santa Maria, CA
National Provider Identifier
1164594487
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(2) exclusion effective Apr 19, 2012.
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY11388
- Practice address
- 500 W Foster Rd
Santa Maria, CA 93455-3620 - Phone
- (805) 934-6380
- Fax
- (805) 934-6381
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY11388 | CA | Primary |
Addresses
Primary practice location
500 W Foster Rd
Santa Maria, CA 93455-3620
Mailing address
1035 Brookside Ave
Santa Maria, CA 93455-3326
Phone (805) 934-6380
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY11388 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164594487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 BROOKSIDE AVE",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934553326",
"telephone_number": "805-934-6380",
"fax_number": "805-934-6381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W FOSTER RD",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934553620",
"telephone_number": "805-934-6380",
"fax_number": "805-934-6381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDERO",
"first_name": "FERNANDO",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY11388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Maria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.