Provider Demographics
NPI:1770353088
Name:RUANTO, FRANCIS
Entity type:Individual
Prefix:
First Name:FRANCIS
Middle Name:
Last Name:RUANTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S WINCHESTER BLVD APT 5306
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2978
Mailing Address - Country:US
Mailing Address - Phone:702-556-3216
Mailing Address - Fax:
Practice Address - Street 1:801 S WINCHESTER BLVD APT 5306
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2978
Practice Address - Country:US
Practice Address - Phone:702-556-3216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51222225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant