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NPI Code Detail

MEDICARE: DIANA RUDESILL PPS

MEDICARE: DIANA RUDESILL PPS
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
1101YS0200XSchool CounselorCA

General Provider Information

NPI Number : 1780480996
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA RUDESILL PPS
Provider Business Mailing Address
First Line : 8681 WINDSOR RD
Second Line :
City : WINDSOR
State : CA
Zip : 95492-9511
Country : US
Telephone Number : 707-687-7535
Fax Number :
Provider Business Practice Location Address
First Line : 8681 WINDSOR RD
Second Line :
City : WINDSOR
State : CA
Zip : 95492-9511
Country : US
Telephone Number : 707-687-7535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2025
Last Update Date : 02/20/2025

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Directions to “ DIANA RUDESILL PPS” Practice Location

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