Healthcare Provider Details

I. General information

NPI: 1114154432
Provider Name (Legal Business Name): CHERYL GARCIA CUESTA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 06/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28093 SMYTH DR
VALENCIA CA
91355-4023
US

IV. Provider business mailing address

28093 SMYTH DR
VALENCIA CA
91355-4023
US

V. Phone/Fax

Practice location:
  • Phone: 661-295-0181
  • Fax: 661-295-9776
Mailing address:
  • Phone: 661-295-0181
  • Fax: 661-295-9776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberOT 1078
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: