Provider Demographics
NPI:1831831270
Name:RUHE, JACOB BENJAMIN
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:BENJAMIN
Last Name:RUHE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAKE
Other - Middle Name:
Other - Last Name:RUHE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:550 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-1643
Mailing Address - Country:US
Mailing Address - Phone:442-257-8513
Mailing Address - Fax:
Practice Address - Street 1:550 W WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-1643
Practice Address - Country:US
Practice Address - Phone:442-257-8513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist