Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Juanita Renee Fuentes, RADT1R1318020818

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1124655642

Juanita Renee Fuentes, RADT1R1318020818 is an Addiction (Substance Use Disorder) Counselor in San Jose, California. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
2
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Practice location Address checks out

102 S 11th St
San Jose, CA 95112-2132
Phone: (408) 998-5191
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Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X

Record details

NPI number1124655642
Entity typeIndividual (Type 1)
GenderFemale
Credentials RADT1R1318020818
Sole proprietorNo
NPI enumeratedMarch 25, 2020
Last updated in NPPESMay 31, 2023
Certification dateMay 31, 2023

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