Provider Demographics
NPI:1407691116
Name:CUEVAS, ALEJANDRA YAZMIN
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:YAZMIN
Last Name:CUEVAS
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 1:1251 N QUINCE AVE
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3140
Mailing Address - Country:US
Mailing Address - Phone:626-394-5756
Mailing Address - Fax:
Practice Address - Street 1:669 W 34TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0067
Practice Address - Country:US
Practice Address - Phone:855-783-9676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030249363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily