Provider Demographics
NPI:1801123070
Name:RUEDA, MONIQUE A
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:A
Last Name:RUEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 WHISPERING PALMS
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-1485
Mailing Address - Country:US
Mailing Address - Phone:562-292-9879
Mailing Address - Fax:
Practice Address - Street 1:3404 WHISPERING PALMS
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-1485
Practice Address - Country:US
Practice Address - Phone:562-292-9879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner