Healthcare Provider Details

I. General information

NPI: 1487461414
Provider Name (Legal Business Name): VIRIDIANA CUERVO ZALETA HUB-CMI, HIPAA CERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2024
Last Update Date: 12/15/2024
Certification Date: 12/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 576
MADERA CA
93639-0576
US

IV. Provider business mailing address

PO BOX 576
MADERA CA
93639-0576
US

V. Phone/Fax

Practice location:
  • Phone: 559-614-9057
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: