Provider Demographics
NPI:1164144572
Name:ABU-RUS, ANA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:
Last Name:ABU-RUS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10391 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4509
Mailing Address - Country:US
Mailing Address - Phone:909-894-7741
Mailing Address - Fax:
Practice Address - Street 1:10391 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4509
Practice Address - Country:US
Practice Address - Phone:909-894-7741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health