Healthcare Provider Details

I. General information

NPI: 1831295468
Provider Name (Legal Business Name): JOSEF RUZEK PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 WILLOW ROAD VA PALO ALTO HEALTH CARE SYSTEM
MENLO PARK CA
94025
US

IV. Provider business mailing address

248 KEN CIRCLE
CAMPBELL CA
95008
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax: 650-617-2701
Mailing address:
  • Phone: 408-378-3693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 14063
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: