Basic Information
Provider Information
NPI: 1710625355
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RUFFO
FirstName: OZIEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 24701 RIVERCHASE DR APT 9209
Address2:  
City: VALENCIA
State: CA
PostalCode: 913551437
CountryCode: US
TelephoneNumber: 2134534074
FaxNumber:  
Practice Location
Address1: 315 CAMINO DEL REMEDIO
Address2:  
City: SANTA BARBARA
State: CA
PostalCode: 931101332
CountryCode: US
TelephoneNumber: 8056815244
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/24/2022
LastUpdateDate: 05/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X95224648CAY193200000X MULTI-SPECIALTY GROUPNursing Service ProvidersRegistered Nurse 

No ID Information.


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