Basic Information
Provider Information
NPI: 1265550685
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CUEVAS
FirstName: PEGGY
MiddleName: LEE
NamePrefix: MS.
NameSuffix:  
Credential: MS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CUEVAS
OtherFirstName: PEGGY
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 2001 THE ALAMEDA
Address2: ALLIANCE FOR COMMUNITY CARE
City: SAN JOSE
State: CA
PostalCode: 951261136
CountryCode: US
TelephoneNumber: 4082617777
FaxNumber: 4082549960
Practice Location
Address1: 206 CALIFORNIA AVE
Address2: ALLIANCE FOR COMMUNITY CARE SERVICE TEAM ADULT CALIFORN
City: PALO ALTO
State: CA
PostalCode: 943061618
CountryCode: US
TelephoneNumber: 6506178340
FaxNumber: 6503215468
Other Information
ProviderEnumerationDate: 03/26/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XNOLICENSECAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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