Provider Demographics
NPI:1518686922
Name:TOGONON, RUBIEANNE
Entity Type:Individual
Prefix:
First Name:RUBIEANNE
Middle Name:
Last Name:TOGONON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-4270
Mailing Address - Country:US
Mailing Address - Phone:707-980-2922
Mailing Address - Fax:
Practice Address - Street 1:100 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-4270
Practice Address - Country:US
Practice Address - Phone:707-980-2922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247000000X
CA247000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA09891200Medicaid