Healthcare Provider Details

I. General information

NPI: 1790153708
Provider Name (Legal Business Name): MARGIE CUEVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2015
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3951 PERFORMANCE DR STE G
SACRAMENTO CA
95838-3264
US

IV. Provider business mailing address

3840 ROSIN CT STE 100
SACRAMENTO CA
95834-1645
US

V. Phone/Fax

Practice location:
  • Phone: 916-921-0828
  • Fax: 916-648-8008
Mailing address:
  • Phone: 916-921-0828
  • Fax: 916-648-8008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number93037
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number93037
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: