Provider Demographics
NPI:1104713247
Name:PALOMINO AYALA, RUBY (NP)
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:
Last Name:PALOMINO AYALA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5249 REEF WAY
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-1062
Mailing Address - Country:US
Mailing Address - Phone:714-728-7003
Mailing Address - Fax:
Practice Address - Street 1:5249 REEF WAY
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93035-1062
Practice Address - Country:US
Practice Address - Phone:714-728-7003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95035076363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health