Provider Demographics
NPI:1912922782
Name:CRIPE, RAQUEL CABRALES (MD)
Entity Type:Individual
Prefix:DR
First Name:RAQUEL
Middle Name:CABRALES
Last Name:CRIPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RAQUEL
Other - Middle Name:
Other - Last Name:CABRALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10470 OLD PLACERVILLER ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:770 MASON ST
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4646
Practice Address - Country:US
Practice Address - Phone:707-427-4900
Practice Address - Fax:707-454-5952
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72802207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A728020Medicaid
CA00A728020OtherBLUE SHIELD
CA00A728021Medicare ID - Type Unspecified
CA00A728020Medicaid