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General NPI Number Information
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NPI Number | 1821545807
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Entity Type | Individual
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Provider Name | VANESSA RUVALCABA
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Gender | Female
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 3301 E 12TH ST STE 259
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City | OAKLAND
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State | CA
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Zip | 94601-2940
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Country | US
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Telephone | 510-846-2511
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Fax |
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Provider Business Mailing Address
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Address Line | 724 LEWELLING BLVD APT 117
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City | SAN LEANDRO
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State | CA
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Zip | 94579-2400
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Country | US
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Telephone | 619-905-9733
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 95004
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 120229
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License Number State | CA
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