Provider Demographics
NPI:1043905169
Name:CUEVAS-CARDENAS, NEREIDA
Entity type:Individual
Prefix:
First Name:NEREIDA
Middle Name:
Last Name:CUEVAS-CARDENAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NEREIDA
Other - Middle Name:
Other - Last Name:CUEVAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:23119 COTTONWOOD AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-9661
Mailing Address - Country:US
Mailing Address - Phone:951-413-5678
Mailing Address - Fax:
Practice Address - Street 1:23119 COTTONWOOD AVE STE 110
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-9661
Practice Address - Country:US
Practice Address - Phone:951-413-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator