Provider Demographics
NPI:1801267083
Name:CUEN, JESSICA RUIZ (NP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RUIZ
Last Name:CUEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:815 WESTWIND DRIVE
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-4363
Mailing Address - Country:US
Mailing Address - Phone:760-554-1503
Mailing Address - Fax:
Practice Address - Street 1:1600 SOUTH IMPERIAL AVENUE
Practice Address - Street 2:SUITE 3
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4242
Practice Address - Country:US
Practice Address - Phone:760-339-2802
Practice Address - Fax:760-355-9520
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95003279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily