Individual
CARLOS ALFRED DELACUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3255 WING ST, SAN DIEGO, CA 92110-4638
(619) 221-8600
Mailing address
1055 E COLORADO BLVD STE 560, PASADENA, CA 91106-2380
(818) 241-6780
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
Primary
—
—
175T00000X
Peer Specialist
—
CA
Other
Enumeration date
11/04/2019
Last updated
03/02/2023
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