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Individual

BRANDON RUVALCABA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1359 N GRAND AVE, COVINA, CA 91724-1016
(626) 430-2853
(626) 331-0035
Mailing address
1359 N GRAND AVE, COVINA, CA 91724-1016
(626) 430-2853
(626) 331-0035

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
ASW91651
CA
1041C0700X
Clinical Social Worker
Primary
110770
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6758
CA
05
7068
CA
05
7420
CA
Enumeration date
08/10/2015
Last updated
03/16/2023
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