Provider Demographics
NPI:1750182143
Name:CUEVAS, CARMEN
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:CUEVAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-2822
Mailing Address - Country:US
Mailing Address - Phone:209-203-8810
Mailing Address - Fax:
Practice Address - Street 1:2234 1ST ST
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-2822
Practice Address - Country:US
Practice Address - Phone:209-203-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)