Healthcare Provider Details

I. General information

NPI: 1104713247
Provider Name (Legal Business Name): RUBY PALOMINO AYALA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5249 REEF WAY
OXNARD CA
93035-1062
US

IV. Provider business mailing address

5249 REEF WAY
OXNARD CA
93035-1062
US

V. Phone/Fax

Practice location:
  • Phone: 714-728-7003
  • Fax:
Mailing address:
  • Phone: 714-728-7003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95035076
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: