Provider Demographics
NPI:1669175154
Name:CWIEK, CATHLYN DOVE (NP)
Entity type:Individual
Prefix:
First Name:CATHLYN
Middle Name:DOVE
Last Name:CWIEK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5452 E HOMECOMING CIR APT A
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:91752-3181
Mailing Address - Country:US
Mailing Address - Phone:909-242-8815
Mailing Address - Fax:909-757-8099
Practice Address - Street 1:9065 HAVEN AVE STE 110
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5429
Practice Address - Country:US
Practice Address - Phone:909-757-5770
Practice Address - Fax:909-757-8099
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-23
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95024688363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health