Provider Demographics
NPI:1982421566
Name:CONTRERAS, RAFAEL GIOVANNI
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:GIOVANNI
Last Name:CONTRERAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6182 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:LOWER LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95457-9730
Mailing Address - Country:US
Mailing Address - Phone:707-227-7201
Mailing Address - Fax:
Practice Address - Street 1:11850 PIERCE ST STE 200
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-5184
Practice Address - Country:US
Practice Address - Phone:951-465-3664
Practice Address - Fax:951-972-8551
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker