Healthcare Provider Details

I. General information

NPI: 1811621345
Provider Name (Legal Business Name): JULIA M RUVINSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7345 MASON AVE
WINNETKA CA
91306-2821
US

IV. Provider business mailing address

7345 MASON AVE
WINNETKA CA
91306-2821
US

V. Phone/Fax

Practice location:
  • Phone: 818-357-1558
  • Fax:
Mailing address:
  • Phone: 818-357-1558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: