Healthcare Provider Details

I. General information

NPI: 1134718737
Provider Name (Legal Business Name): RUKHSANA U MALIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2021
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24301 SOUTHLAND DR STE 510
HAYWARD CA
94545-1540
US

IV. Provider business mailing address

110 RYAN INDUSTRIAL CT STE 3AND4
SAN RAMON CA
94583-1592
US

V. Phone/Fax

Practice location:
  • Phone: 925-915-0610
  • Fax:
Mailing address:
  • Phone: 510-315-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90313
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: