Provider Demographics
NPI:1922444058
Name:STANKOWSKI, RUTH
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:
Last Name:STANKOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:ANN
Other - Last Name:GOOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:771 SOMERSET PL
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-2839
Mailing Address - Country:US
Mailing Address - Phone:925-676-3934
Mailing Address - Fax:
Practice Address - Street 1:771 SOMERSET PL
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-2839
Practice Address - Country:US
Practice Address - Phone:925-676-3934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA359570163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse