Provider Demographics
NPI:1700456738
Name:CUEVAS-ALTAMIRANO, MARIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CUEVAS-ALTAMIRANO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17203 JASMINE ST
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395
Mailing Address - Country:US
Mailing Address - Phone:760-881-3377
Mailing Address - Fax:760-881-3379
Practice Address - Street 1:17203 JASMINE ST
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395
Practice Address - Country:US
Practice Address - Phone:760-881-3377
Practice Address - Fax:760-881-3379
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026305163W00000X
CA95020314363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse