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Individual

MELISSA RUBALCAVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.P.T.

Contact information

Practice address
4411 E KINGS CANYON RD # 319, FRESNO, CA 93702-3604
(559) 600-2382
Mailing address
3433 W SHAW AVE STE 102, FRESNO, CA 93711-3229
(559) 558-4051

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
32589
CA
167G00000X
Licensed Psychiatric Technician
32589
CA
167G00000X
Licensed Psychiatric Technician
Primary
PT32589
CA
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1659419828
CA
Enumeration date
03/12/2007
Last updated
10/07/2021
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