Provider Demographics
NPI:1659742369
Name:CUEVAS, MARKEE
Entity Type:Individual
Prefix:DR
First Name:MARKEE
Middle Name:
Last Name:CUEVAS
Suffix:
Gender:F
Credentials:
Other - Prefix:PROF
Other - First Name:LACEY
Other - Middle Name:
Other - Last Name:PEDERSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:601 W GRANGER AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4134
Mailing Address - Country:US
Mailing Address - Phone:209-838-9940
Mailing Address - Fax:
Practice Address - Street 1:19951 EAST HIGHWAY 120
Practice Address - Street 2:
Practice Address - City:ESCALON
Practice Address - State:CA
Practice Address - Zip Code:95320
Practice Address - Country:US
Practice Address - Phone:209-838-9940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator