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NPI Code Detail

MEDICARE: CHERYL RUEDI

MEDICARE: CHERYL RUEDI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorLCI04240315CA

General Provider Information

NPI Number : 1679023360
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL RUEDI
Provider Business Mailing Address
First Line : 4626 N GRAND AVE
Second Line :
City : COVINA
State : CA
Zip : 91724-2055
Country : US
Telephone Number : 626-331-5316
Fax Number : 626-332-2219
Provider Business Practice Location Address
First Line : 4626 N GRAND AVE
Second Line :
City : COVINA
State : CA
Zip : 91724-2055
Country : US
Telephone Number : 626-331-5316
Fax Number : 626-332-2219
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2016
Last Update Date : 10/06/2016

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Directions to “ CHERYL RUEDI ” Practice Location

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