Provider Demographics
NPI:1700694700
Name:DUSSERT, RUTH ANN (LE)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:DUSSERT
Suffix:
Gender:F
Credentials:LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 FOXEN DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-2510
Mailing Address - Country:US
Mailing Address - Phone:805-259-6141
Mailing Address - Fax:
Practice Address - Street 1:5276 HOLLISTER AVE STE 104
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-3052
Practice Address - Country:US
Practice Address - Phone:805-964-5276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-21
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9635246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other