Provider Demographics
NPI:1972098952
Name:CUPID, KASAUNDRA
Entity type:Individual
Prefix:
First Name:KASAUNDRA
Middle Name:
Last Name:CUPID
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 1:1180 DUTCH MILL RD
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-8711
Mailing Address - Country:US
Mailing Address - Phone:951-692-2912
Mailing Address - Fax:
Practice Address - Street 1:25873 HEMET ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-5026
Practice Address - Country:US
Practice Address - Phone:951-927-2482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional