Provider Demographics
NPI:1578215869
Name:CAZARES, RAFAEL (LMFT)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:
Last Name:CAZARES
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 INLAND EMPIRE BLVD UNIT 2138
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-1871
Mailing Address - Country:US
Mailing Address - Phone:909-968-7073
Mailing Address - Fax:
Practice Address - Street 1:25230 DRACAEA AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-4238
Practice Address - Country:US
Practice Address - Phone:909-968-7073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist