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General NPI Number Information
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NPI Number | 1790621860
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Entity Type | Organization
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Legal Business Name | RUBY'S PLACE
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 370 W ARBOR AVE
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City | TRACY
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State | CA
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Zip | 95304-9452
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Country | US
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Telephone | 916-878-9458
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Fax |
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Provider Business Mailing Address
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Address Line | 20880 BAKER RD
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5729
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Country | US
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Telephone | 916-878-9458
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SOPHORA ACHESON
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Credential | LMFT
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Telephone | 510-519-8083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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