Provider Demographics
NPI:1871205344
Name:VILCHES, RAFAEL STEVE
Entity type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:STEVE
Last Name:VILCHES
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:RAWFA-EL
Other - Middle Name:
Other - Last Name:VYXWZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1701 PINE ST APT 212
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-3432
Mailing Address - Country:US
Mailing Address - Phone:925-207-3775
Mailing Address - Fax:
Practice Address - Street 1:313 LENNON LN STE 100
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2460
Practice Address - Country:US
Practice Address - Phone:925-956-2148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10026366OtherKAISER