Provider Demographics
NPI:1891228011
Name:RALEIGH, RUTH EMMA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MISS
First Name:RUTH
Middle Name:EMMA
Last Name:RALEIGH
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1610 SOUTH MAYFLOWER AVENUE
Mailing Address - Street 2:UNIT C
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016
Mailing Address - Country:US
Mailing Address - Phone:818-515-6436
Mailing Address - Fax:626-357-9832
Practice Address - Street 1:455 W MONTANA ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-1327
Practice Address - Country:US
Practice Address - Phone:626-993-1222
Practice Address - Fax:626-486-9693
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA416377163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health