Provider Demographics
NPI:1962166454
Name:VELARDE, ADRIANA CUEVAS (CPM, IBCLC)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:CUEVAS
Last Name:VELARDE
Suffix:
Gender:F
Credentials:CPM, IBCLC
Other - Prefix:
Other - First Name:ADRIANA
Other - Middle Name:
Other - Last Name:CUEVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3701 LAGUNA WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-2922
Mailing Address - Country:US
Mailing Address - Phone:951-813-5166
Mailing Address - Fax:
Practice Address - Street 1:3701 LAGUNA WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-2922
Practice Address - Country:US
Practice Address - Phone:951-813-5166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-303180174N00000X
176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty