Provider Demographics
NPI:1437822442
Name:RAVULAPALLI, BHAVANI (LCSW)
Entity Type:Individual
Prefix:
First Name:BHAVANI
Middle Name:
Last Name:RAVULAPALLI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BHAVANI
Other - Middle Name:
Other - Last Name:RAVULAPALLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1045 CALLANDER WAY
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-6100
Mailing Address - Country:US
Mailing Address - Phone:916-741-8992
Mailing Address - Fax:
Practice Address - Street 1:510 PLAZA DR STE 170
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4790
Practice Address - Country:US
Practice Address - Phone:916-351-9400
Practice Address - Fax:916-351-9449
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW874561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical