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General NPI Number Information
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NPI Number | 1568704641
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Entity Type | Individual
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Provider Name | RUTH NICOLE MONDOLFI D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 16035 CAPUTO DR STE B
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City | MORGAN HILL
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State | CA
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Zip | 95037-5528
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Country | US
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Telephone | 303-885-9670
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Fax |
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Provider Business Mailing Address
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Address Line | 1012 ORONOCO ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2237
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Country | US
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Telephone | 303-885-9670
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 1740
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20A15625
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 007332
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License Number State | AZ
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