Provider Demographics
NPI:1407094741
Name:CUENCA, CAROLA I (NP)
Entity Type:Individual
Prefix:MISS
First Name:CAROLA
Middle Name:I
Last Name:CUENCA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9057 SOQUEL DR
Mailing Address - Street 2:AB
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4001
Mailing Address - Country:US
Mailing Address - Phone:831-685-1125
Mailing Address - Fax:831-685-1128
Practice Address - Street 1:9057 SOQUEL DR
Practice Address - Street 2:AB
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-4001
Practice Address - Country:US
Practice Address - Phone:831-685-1125
Practice Address - Fax:831-685-1128
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNAT1000467175F00000X
175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath
No175F00000XOther Service ProvidersNaturopath