Healthcare Provider Details

I. General information

NPI: 1568000529
Provider Name (Legal Business Name): CLAIRE CUENCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2019
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31021 TEMECULA PKWY
TEMECULA CA
92592-2991
US

IV. Provider business mailing address

29037 AUBREY CIR
WINCHESTER CA
92596-9614
US

V. Phone/Fax

Practice location:
  • Phone: 951-303-9417
  • Fax:
Mailing address:
  • Phone: 951-501-9539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77748
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: