Provider Demographics
NPI:1780729905
Name:RUVALCABA, RAQUEL SOLIS (MS, LMFT)
Entity type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:SOLIS
Last Name:RUVALCABA
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 N MOUNTAIN AVE # 0
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3659
Mailing Address - Country:US
Mailing Address - Phone:909-579-8100
Mailing Address - Fax:
Practice Address - Street 1:934 N MOUNTAIN AVE STE C
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3659
Practice Address - Country:US
Practice Address - Phone:909-579-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47542106H00000X
CAMFC47622106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist