Provider Demographics
NPI:1316698376
Name:RUVALCABA, DENISE ERICA (RN)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:ERICA
Last Name:RUVALCABA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27431 SAN BERNARDINO AVE APT 155
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-5081
Mailing Address - Country:US
Mailing Address - Phone:818-599-3530
Mailing Address - Fax:
Practice Address - Street 1:27431 SAN BERNARDINO AVE APT 155
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-5081
Practice Address - Country:US
Practice Address - Phone:818-599-3530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95270595163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse