Provider Demographics
NPI:1467289728
Name:CUCE, ANDREA CORINA (SUDCC 19084)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:CORINA
Last Name:CUCE
Suffix:
Gender:F
Credentials:SUDCC 19084
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W MORRISON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-6124
Mailing Address - Country:US
Mailing Address - Phone:805-347-3338
Mailing Address - Fax:866-404-4007
Practice Address - Street 1:401 W MORRISON AVE STE B
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-6124
Practice Address - Country:US
Practice Address - Phone:805-347-3338
Practice Address - Fax:866-729-9741
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASUDCC19084101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty