Healthcare Provider Details

I. General information

NPI: 1932062619
Provider Name (Legal Business Name): RUTH OPPENHEIMER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20283 SANTA MARIA AVE UNIT 2944
CASTRO VALLEY CA
94546-5035
US

IV. Provider business mailing address

20283 SANTA MARIA AVE UNIT 2944
CASTRO VALLEY CA
94546-5035
US

V. Phone/Fax

Practice location:
  • Phone: 510-766-1064
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: