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General NPI Number Information
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NPI Number | 1366079790
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Entity Type | Individual
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Provider Name | JENNIFER RUONA DPT
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Gender | Female
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Dates
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Enumeration Date | 03/25/2020
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 720 27TH ST APT D
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City | SACRAMENTO
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State | CA
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Zip | 95816-4175
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Country | US
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Telephone | 530-368-7037
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2710
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City | GRANITE BAY
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State | CA
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Zip | 95746-2710
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Country | US
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Telephone | 916-932-1210
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 297347
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License Number State | CA
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