Nicole Renae Cuahutle

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

20549 Valley Blvd
Walnut, CA 91789-2730

Phone

(809) 594-2762

NPI assigned

Apr 16, 2019

Last updated

Jul 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Talk Therapy Center

  dba Talk Therapy Center

  • Marriage & Family Therapist
  • Riverside, CA
  • NPI 1174089411
  Medicare reassignment NPD
• Institute for the Redesign of Learning

  dba Almansor Clinical Serivces

  • Marriage & Family Therapist
  • South Pasadena, CA
  • NPI 1124212295

  Mental Health

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1104489210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PASADENA AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302919",
            "telephone_number": "323-344-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20549 VALLEY BLVD",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892730",
            "telephone_number": "809-594-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUAHUTLE",
        "first_name": "NICOLE",
        "middle_name": "RENAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT120879",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7708",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7184",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7667",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7368",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonita Louise Conway, LCSW
• Russell Cook, R.T.
• Ramon Coronado, LCSW
• Vanessa Cortez
• Cynthia Cruz-Porto, NP
• Kyle Dalan, PHARMD
• Jamie Daniels
• David Pace D.D.S. Inc.
• Laurentino Lozada De Guia Jr., DMD
• Concepcion De Guzman, NP

• Marriage & Family Therapist in Walnut, CA
• Providers in Walnut, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.