Provider Demographics
NPI:1235324021
Name:RUVALCABA, BERTHA PICAZO (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BERTHA
Middle Name:PICAZO
Last Name:RUVALCABA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:BERTHA
Other - Middle Name:
Other - Last Name:PICAZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:2130 STOCKTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1337
Mailing Address - Country:US
Mailing Address - Phone:916-874-3662
Mailing Address - Fax:
Practice Address - Street 1:2130 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1337
Practice Address - Country:US
Practice Address - Phone:916-874-3662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA605741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical