Provider Demographics
NPI:1316313315
Name:CUBAS, JOSELINE
Entity type:Individual
Prefix:
First Name:JOSELINE
Middle Name:
Last Name:CUBAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6434
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91802-6434
Mailing Address - Country:US
Mailing Address - Phone:818-216-3241
Mailing Address - Fax:
Practice Address - Street 1:10 W BAY STATE ST UNIT 6434
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91802-2880
Practice Address - Country:US
Practice Address - Phone:818-216-3241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF87236106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist