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General NPI Number Information
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NPI Number | 1104199058
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Entity Type | Individual
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Provider Name | RUTH K DOYLE
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Gender | Female
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 10/14/2014
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Provider Practice Location Address
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Address Line | 484 E SAN FERNANDO ST
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City | SAN JOSE
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State | CA
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Zip | 95112-3513
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Country | US
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Telephone | 408-293-0422
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Fax | 408-277-2474
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Provider Business Mailing Address
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Address Line | 290 IOOF AVE
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City | GILROY
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State | CA
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Zip | 95020-5204
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Country | US
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Telephone | 408-846-2100
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Fax | 408-846-2489
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF# 80624
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License Number State | CA
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