Provider Demographics
NPI:1326397019
Name:FRANZ RUDAS
Entity Type:Organization
Organization Name:FRANZ RUDAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHIATRIC TECHNICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANZ
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-386-7472
Mailing Address - Street 1:644 ANTIQUITY DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-4050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:644 ANTIQUITY DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-4050
Practice Address - Country:US
Practice Address - Phone:707-386-7472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34967251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health