Provider Demographics
NPI:1679465181
Name:CARDENAS FLORES, JOEL
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:CARDENAS FLORES
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 1:5571 WALNUT BLOSSOM DR
Mailing Address - Street 2:APT 2
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123
Mailing Address - Country:US
Mailing Address - Phone:408-585-8542
Mailing Address - Fax:
Practice Address - Street 1:5571 WALNUT BLOSSOM DR
Practice Address - Street 2:APT 2
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123
Practice Address - Country:US
Practice Address - Phone:408-585-8542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01315573376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide