Healthcare Provider Details

I. General information

NPI: 1346546694
Provider Name (Legal Business Name): ALBERTO CUEVAS JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2011
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3209 GALINDO ST
OAKLAND CA
94601-2507
US

IV. Provider business mailing address

1319 FRUITVALE AVE
OAKLAND CA
94601-2927
US

V. Phone/Fax

Practice location:
  • Phone: 510-532-5995
  • Fax: 510-436-4214
Mailing address:
  • Phone: 510-535-2303
  • Fax: 510-535-2346

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: