Provider Demographics
NPI:1013692433
Name:CUBANGBANG, RUBY ANN AUREA (NP)
Entity Type:Individual
Prefix:MRS
First Name:RUBY ANN
Middle Name:AUREA
Last Name:CUBANGBANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2429 RAJKOVICH WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-3027
Mailing Address - Country:US
Mailing Address - Phone:209-598-3125
Mailing Address - Fax:
Practice Address - Street 1:2429 RAJKOVICH WAY
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95212-3027
Practice Address - Country:US
Practice Address - Phone:209-598-3125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA754280163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse