Provider Demographics
NPI:1841702818
Name:CUATICO, CHERI (RN, PHN)
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:
Last Name:CUATICO
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13063 CALLE CABALLEROS
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2913
Mailing Address - Country:US
Mailing Address - Phone:619-721-5445
Mailing Address - Fax:
Practice Address - Street 1:5055 RUFFIN RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1617
Practice Address - Country:US
Practice Address - Phone:858-573-7308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82948163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health