Provider Demographics
NPI:1932279791
Name:VYLASEK, RUTH ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ANN
Last Name:VYLASEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-4536
Mailing Address - Country:US
Mailing Address - Phone:925-456-9212
Mailing Address - Fax:925-292-8979
Practice Address - Street 1:1111 E STANLEY BLVD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4115
Practice Address - Country:US
Practice Address - Phone:925-213-1385
Practice Address - Fax:925-243-0127
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA551968163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management