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NPI Code Detail

MEDICARE: MRS. RUBY LYNN CARR

MEDICARE:  MRS. RUBY LYNN CARR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1730369471
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RUBY LYNN CARR
Provider Business Mailing Address
First Line : 15935 SPRING OAKS RD SPC 162
Second Line :
City : EL CAJON
State : CA
Zip : 92021-2692
Country : US
Telephone Number : 619-258-7609
Fax Number :
Provider Business Practice Location Address
First Line : 15935 SPRING OAKS RD SPC 162
Second Line :
City : EL CAJON
State : CA
Zip : 92021-2692
Country : US
Telephone Number : 619-258-7609
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2007
Last Update Date : 11/09/2007

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Directions to “ MRS. RUBY LYNN CARR ” Practice Location

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