Individual provider Active NPI

Olga Rubalcava

  • Dental Hygienist
  • Riverside, CA
National Provider Identifier
1376993766
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
28529 Issued in CA
Practice address
5911 Steve St
Riverside, CA 92509-4784
Phone
(951) 990-9643
NPI assigned
Jun 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 28529 CA Primary

Addresses

Primary practice location

5911 Steve St
Riverside, CA 92509-4784

Mailing address

5911 Steve St
Riverside, CA 92509-4784
Phone (951) 990-9643

Other identifiers 1

IdentifierTypeStateIssuer
28529MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28529CAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1376993766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 STEVE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925094784",
            "telephone_number": "951-990-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 STEVE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925094784",
            "telephone_number": "951-990-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBALCAVA",
        "first_name": "OLGA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "28529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28529",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.