Healthcare Provider Details

I. General information

NPI: 1104437508
Provider Name (Legal Business Name): NICOLE CUTHILL MA, PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2020
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3380 14TH ST
RIVERSIDE CA
92501-3810
US

IV. Provider business mailing address

525 TECHNOLOGY CT STE 105
RIVERSIDE CA
92507-2181
US

V. Phone/Fax

Practice location:
  • Phone: 951-343-1200
  • Fax:
Mailing address:
  • Phone: 951-686-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: