Healthcare Provider Details

I. General information

NPI: 1437497005
Provider Name (Legal Business Name): MONICA YVONNE RUEGG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 03/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 E OCEAN BLVD STE 400
LONG BEACH CA
90802-4806
US

IV. Provider business mailing address

2143 CHEVY CHASE DR
BREA CA
92821-5908
US

V. Phone/Fax

Practice location:
  • Phone: 888-808-7838
  • Fax:
Mailing address:
  • Phone: 888-808-7838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number1414
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: