Provider Demographics
NPI:1144414186
Name:RUBEN, KERRY ANN (RN/PHN)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:ANN
Last Name:RUBEN
Suffix:
Gender:F
Credentials:RN/PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9333 TECH CENTER DR
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2583
Mailing Address - Country:US
Mailing Address - Phone:916-875-5000
Mailing Address - Fax:
Practice Address - Street 1:9333 TECH CENTER DR
Practice Address - Street 2:SUITE 800
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2583
Practice Address - Country:US
Practice Address - Phone:916-875-5000
Practice Address - Fax:916-875-6731
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN495757163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health