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General NPI Number Information
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NPI Number | 1386781466
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Entity Type | Individual
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Provider Name | RAQUEL NATALIA NIEVES MD
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1133 E STANLEY BLVD STE 103
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City | LIVERMORE
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State | CA
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Zip | 94550-4270
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Country | US
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Telephone | 925-455-5050
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Fax | 925-455-5084
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Provider Business Mailing Address
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Address Line | 1133 E STANLEY BLVD STE 103
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City | LIVERMORE
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State | CA
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Zip | 94550-4270
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Country | US
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Telephone | 925-455-5050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA09062400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C150185
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License Number State | CA
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