MEDICARE: MRS. ESTHER CUEVAS MCCOY L.C.S.W.

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	1041C0700X	Clinical Social Worker	LCS 17773	CA

General Provider Information

NPI Number	:	1366534984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ESTHER CUEVAS MCCOY L.C.S.W.

Provider Business Mailing Address
First Line	:	3125 MYERS ST
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92503-5527
Country	:	US
Telephone Number	:	951-358-4850
Fax Number	:	951-358-4852

Provider Business Practice Location Address
First Line	:	3125 MYERS ST
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92503-5527
Country	:	US
Telephone Number	:	951-358-4850
Fax Number	:	951-358-4852

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

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	12/03/2014

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