Provider Demographics
NPI:1457534224
Name:RUACHO, ANTHONY (CAS REG)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:RUACHO
Suffix:
Gender:M
Credentials:CAS REG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SUN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3714
Mailing Address - Country:US
Mailing Address - Phone:831-753-5145
Mailing Address - Fax:831-753-6007
Practice Address - Street 1:8 SUN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3714
Practice Address - Country:US
Practice Address - Phone:831-753-5145
Practice Address - Fax:831-753-6007
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAS REG #5131101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5131OtherC.A.S. REG.