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General NPI Number Information
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NPI Number | 1598568545
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Entity Type | Individual
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Provider Name | ALANNAH ELYSE TONGSON RUIZ DPT
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Gender |
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 401 BICENTENNIAL WAY
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City | SANTA ROSA
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State | CA
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Zip | 95403-2149
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Country | US
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Telephone | 707-393-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 5512 BORDEAUX CT
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City | VALLEJO
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State | CA
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Zip | 94591-6308
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Country | US
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Telephone |
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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 | 307807
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License Number State | CA
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