Healthcare Provider Details

I. General information

NPI: 1538038641
Provider Name (Legal Business Name): ARIANNA MARIE CUEVAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/07/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 RECHE CANYON RD APT 705
COLTON CA
92324-9762
US

IV. Provider business mailing address

1333 RECHE CANYON RD APT 705
COLTON CA
92324-9762
US

V. Phone/Fax

Practice location:
  • Phone: 951-662-0364
  • Fax:
Mailing address:
  • Phone: 951-662-0364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberW9558101
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: