Provider Demographics
NPI:1629954953
Name:BECERRA RUVALCABA, YANELI
Entity type:Individual
Prefix:
First Name:YANELI
Middle Name:
Last Name:BECERRA RUVALCABA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 S LINCOLN ST SPC B27
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-8510
Mailing Address - Country:US
Mailing Address - Phone:805-554-9567
Mailing Address - Fax:
Practice Address - Street 1:120 MARY DR
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-3920
Practice Address - Country:US
Practice Address - Phone:805-361-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3CF6244D13171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach