Healthcare Provider Details

I. General information

NPI: 1609759133
Provider Name (Legal Business Name): ANAHI CUAUTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47825 OASIS ST
INDIO CA
92201-6950
US

IV. Provider business mailing address

404 KONA LN
PALM SPRINGS CA
92264-9020
US

V. Phone/Fax

Practice location:
  • Phone: 760-863-8283
  • Fax:
Mailing address:
  • Phone: 760-409-7871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT155975
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC19663
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: