Healthcare Provider Details

I. General information

NPI: 1518292259
Provider Name (Legal Business Name): MR. RUBEN CUEVA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 10/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E BELMONT AVE
FRESNO CA
93701-1502
US

IV. Provider business mailing address

846 W TERRACE AVE
FRESNO CA
93705-4540
US

V. Phone/Fax

Practice location:
  • Phone: 559-237-3420
  • Fax:
Mailing address:
  • Phone: 559-237-3420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: