1265550685 NPI number — MS. PEGGY LEE CUEVAS MS

Table of content: MS. PEGGY LEE CUEVAS MS (NPI 1265550685)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265550685 NPI number — MS. PEGGY LEE CUEVAS MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CUEVAS
Provider First Name:
PEGGY
Provider Middle Name:
LEE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CUEVAS
Provider Other First Name:
PEGGY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265550685
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2001 THE ALAMEDA
Provider Second Line Business Mailing Address:
ALLIANCE FOR COMMUNITY CARE
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95126-1136
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-261-7777
Provider Business Mailing Address Fax Number:
408-254-9960

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
206 CALIFORNIA AVE
Provider Second Line Business Practice Location Address:
ALLIANCE FOR COMMUNITY CARE SERVICE TEAM ADULT CALIFORN
Provider Business Practice Location Address City Name:
PALO ALTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94306-1618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-617-8340
Provider Business Practice Location Address Fax Number:
650-321-5468
Provider Enumeration Date:
03/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  NOLICENSE , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)