Provider Demographics
NPI:1255792677
Name:CUADRO, NICOLE CRISTINE MAURICIO (PSYD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:CRISTINE MAURICIO
Last Name:CUADRO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:CRISTINE MAURICIO
Other - Last Name:AMARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:64 PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-1244
Mailing Address - Country:US
Mailing Address - Phone:415-757-8306
Mailing Address - Fax:
Practice Address - Street 1:NAVY MEDICAL READINESS & TRAINING COMMAND
Practice Address - Street 2:1145 STURGIS ROAD
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92278-1513
Practice Address - Country:US
Practice Address - Phone:760-830-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)