Individual provider Active NPI

Miguel Ruvalcaba, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Yorba Linda, CA
National Provider Identifier
1124471628
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95003841 Issued in CA
Practice address
5111 Eureka Ave
Yorba Linda, CA 92886-3970
Phone
(562) 534-8473
NPI assigned
Jul 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95003841 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201601589NP-PP OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95003841 CA Primary
Family Nurse Practitioner 363LF0000X 201501589NP-PP OR

Addresses

Primary practice location

5111 Eureka Ave
Yorba Linda, CA 92886-3970

Mailing address

5111 Eureka Ave
Yorba Linda, CA 92886-3970
Phone (562) 534-8473

Other identifiers 1

IdentifierTypeStateIssuer
500711426MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160815001318 OR Practitioner - Nurse Practitioner 5698069680 Reassigns benefits to 1 organization
I20260320003886 CA Practitioner - Nurse Practitioner 5698069680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95003841CAMDFamily Nurse Practitioner
201501589NP-PPORMDFamily Nurse Practitioner
201601589NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1124471628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 EUREKA AVE",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863970",
            "telephone_number": "562-534-8473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 EUREKA AVE",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863970",
            "telephone_number": "562-534-8473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUVALCABA",
        "first_name": "MIGUEL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-20",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95003841",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201601589NP-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95003841",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201501589NP-PP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500711426",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorba Linda, CA

Sources for this page

Verify at the official NPI Registry.