Healthcare Provider Details

I. General information

NPI: 1285578179
Provider Name (Legal Business Name): MR. MOISES JESUS RUBALCAVA-MARIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 CENTRAL AVE
SALINAS CA
93901-2651
US

IV. Provider business mailing address

134 CENTRAL AVE
SALINAS CA
93901-2651
US

V. Phone/Fax

Practice location:
  • Phone: 831-208-6207
  • Fax: 844-209-1290
Mailing address:
  • Phone: 831-208-6207
  • Fax: 844-209-1290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: