Healthcare Provider Details

I. General information

NPI: 1861326530
Provider Name (Legal Business Name): MR. JUWAN EDWARD CUMMINGS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 SOLANO AVE
BERKELEY CA
94707-2297
US

IV. Provider business mailing address

8684 WESTMAN AVE
WHITTIER CA
90606-3428
US

V. Phone/Fax

Practice location:
  • Phone: 559-514-3545
  • Fax:
Mailing address:
  • Phone: 559-514-3545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number160015
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: