Provider Demographics
NPI:1679892673
Name:CUEVAS, HEIDI
Entity Type:Individual
Prefix:MISS
First Name:HEIDI
Middle Name:
Last Name:CUEVAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 LONG BEACH BLVD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2011
Mailing Address - Country:US
Mailing Address - Phone:213-385-5100
Mailing Address - Fax:213-383-1820
Practice Address - Street 1:4300 LONG BEACH BLVD
Practice Address - Street 2:SUITE 700
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2011
Practice Address - Country:US
Practice Address - Phone:213-385-5100
Practice Address - Fax:213-383-1820
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-31
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner