Provider Demographics
NPI:1720575590
Name:RUGGIERO, RICCARDO LUCIEN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:RICCARDO
Middle Name:LUCIEN
Last Name:RUGGIERO
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:RICHIE
Other - Middle Name:LUCIEN
Other - Last Name:RUGGIERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:1855 W KATELLA AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-3432
Mailing Address - Country:US
Mailing Address - Phone:714-790-6381
Mailing Address - Fax:714-956-3591
Practice Address - Street 1:1855 W KATELLA AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-3451
Practice Address - Country:US
Practice Address - Phone:714-399-3480
Practice Address - Fax:714-956-3591
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022071163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse