Provider Demographics
NPI:1790811651
Name:CAPACETE, RAQUEL CRISTINA (BA)
Entity Type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:CRISTINA
Last Name:CAPACETE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:734 N WALNUTHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-1245
Mailing Address - Country:US
Mailing Address - Phone:626-337-5382
Mailing Address - Fax:
Practice Address - Street 1:11741 TELEGRAPH RD STE G
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3687
Practice Address - Country:US
Practice Address - Phone:562-942-8256
Practice Address - Fax:562-942-9789
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health