Basic Information
| Provider Information | |||||||||
| NPI: | 1235112483 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUTHRAUFF | ||||||||
| FirstName: | BREANNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2230 STOCKTON BLVD | ||||||||
| Address2: | DEPT OF PSYCHIATRY | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958171419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167342972 | ||||||||
| FaxNumber: | 9167343384 | ||||||||
| Practice Location | |||||||||
| Address1: | 2230 STOCKTON BLVD | ||||||||
| Address2: | DEPT OF PSYCHIATRY | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958171419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167342972 | ||||||||
| FaxNumber: | 9167343384 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2005 | ||||||||
| LastUpdateDate: | 07/17/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | A61021 | CA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084P0800X | A61021 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 208VP0000X | A61021 | CA | N | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine |
No ID Information.