Provider Demographics
NPI:1639580434
Name:RUKA, VALORIE (PT)
Entity Type:Individual
Prefix:MS
First Name:VALORIE
Middle Name:
Last Name:RUKA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 C ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-5100
Mailing Address - Country:US
Mailing Address - Phone:619-550-3026
Mailing Address - Fax:619-238-4245
Practice Address - Street 1:427 C ST
Practice Address - Street 2:SUITE 212
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-5100
Practice Address - Country:US
Practice Address - Phone:619-550-3026
Practice Address - Fax:619-238-4245
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 22838167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician