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General NPI Number Information
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NPI Number | 1134452543
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Entity Type | Individual
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Provider Name | KELLEY DAWN CUEVAS CPHT
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Gender | Female
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Dates
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Enumeration Date | 09/16/2009
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Last Update Date | 09/16/2009
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Provider Practice Location Address
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Address Line | 5125 SKYWAY STE F
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City | PARADISE
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State | CA
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Zip | 95969-5624
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Country | US
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Telephone | 530-876-2525
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Fax | 530-876-2528
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Provider Business Mailing Address
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Address Line | 5354 NEWLAND RD
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City | PARADISE
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State | CA
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Zip | 95969-5330
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Country | US
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Telephone | 530-588-2049
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Fax | 530-876-2528
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 52109
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License Number State | CA
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