MEDICARE: DESIREE ARLENE CUEVAS PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY30836	CA

General Provider Information

NPI Number	:	1023674884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESIREE ARLENE CUEVAS PSY.D.

Provider Business Mailing Address
First Line	:	20594 W VALLEY VIEW DR
Second Line	:
City	:	BUCKEYE
State	:	AZ
Zip	:	85396-1734
Country	:	US
Telephone Number	:	626-384-1755
Fax Number	:

Provider Business Practice Location Address
First Line	:	20594 W VALLEY VIEW DR
Second Line	:
City	:	BUCKEYE
State	:	AZ
Zip	:	85396-1734
Country	:	US
Telephone Number	:	626-384-1755
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	01/17/2024

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