Provider Demographics
NPI:1265247456
Name:CUEVA, WALTER A (AMFT)
Entity type:Individual
Prefix:
First Name:WALTER
Middle Name:A
Last Name:CUEVA
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:778 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-3114
Mailing Address - Country:US
Mailing Address - Phone:805-791-4243
Mailing Address - Fax:
Practice Address - Street 1:15720 VENTURA BLVD STE 420
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4711
Practice Address - Country:US
Practice Address - Phone:818-927-0478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT147991103TC0700X
103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling