Provider Demographics
NPI:1336696988
Name:RUDA, FREYA CERNA (APN)
Entity Type:Individual
Prefix:MRS
First Name:FREYA
Middle Name:CERNA
Last Name:RUDA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5316 TERSK WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-3224
Mailing Address - Country:US
Mailing Address - Phone:224-302-2513
Mailing Address - Fax:
Practice Address - Street 1:8191 TIMBERLAKE WAY STE 350
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5419
Practice Address - Country:US
Practice Address - Phone:916-688-9994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209014686363LF0000X
CA95008941363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily