Healthcare Provider Details

I. General information

NPI: 1033032164
Provider Name (Legal Business Name): RUKUYA HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 71ST AVE UNIT 411
OAKLAND CA
94621-3454
US

IV. Provider business mailing address

777 BROADWAY APT 508
OAKLAND CA
94607-4180
US

V. Phone/Fax

Practice location:
  • Phone: 510-593-0227
  • Fax:
Mailing address:
  • Phone: 470-658-6899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: