Provider Demographics
NPI:1710739792
Name:CUAHUTLE, ISELA (COUNSELOR-ADDICTION)
Entity type:Individual
Prefix:
First Name:ISELA
Middle Name:
Last Name:CUAHUTLE
Suffix:
Gender:F
Credentials:COUNSELOR-ADDICTION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 S ANITA DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3355
Mailing Address - Country:US
Mailing Address - Phone:949-749-2500
Mailing Address - Fax:
Practice Address - Street 1:12021 WILMINGTON AVE STE 101
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-3019
Practice Address - Country:US
Practice Address - Phone:310-365-7414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)