Healthcare Provider Details

I. General information

NPI: 1629094057
Provider Name (Legal Business Name): LAURA M CUEVA-MILLER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3598 NELSON ST
RIVERSIDE CA
92506-3014
US

IV. Provider business mailing address

3598 NELSON ST
RIVERSIDE CA
92506-3014
US

V. Phone/Fax

Practice location:
  • Phone: 951-788-6006
  • Fax:
Mailing address:
  • Phone: 951-788-6006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY21131
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: