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General NPI Number Information
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NPI Number | 1821611492
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Entity Type | Individual
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Provider Name | RAVEN NAVARRETE
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Gender | Female
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Dates
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Enumeration Date | 05/18/2020
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 1529 E PALMDALE BLVD STE 210
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City | PALMDALE
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State | CA
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Zip | 93550-2029
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Country | US
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Telephone | 323-472-1953
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Fax |
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Provider Business Mailing Address
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Address Line | 1529 E PALMDALE BLVD STE 210
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City | PALMDALE
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State | CA
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Zip | 93550-2029
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Country | US
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Telephone | 661-272-9996
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 10312
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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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 | 127935
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT127935
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License Number State | CA
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