Healthcare Provider Details

I. General information

NPI: 1972621928
Provider Name (Legal Business Name): IRMA CUEVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1617 CRAVENS AVE
TORRANCE CA
90501-3203
US

IV. Provider business mailing address

410 CAMINO REAL
REDONDO BEACH CA
90277-3815
US

V. Phone/Fax

Practice location:
  • Phone: 310-328-0855
  • Fax: 310-328-9636
Mailing address:
  • Phone: 310-316-1212
  • Fax: 310-316-4411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: