Provider Demographics
NPI:1841706546
Name:RUTH, CASSIE (NMD)
Entity type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:
Last Name:RUTH
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8898 NAVAJO RD STE C304
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-2141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8900 GROSSMONT BLVD # 4-7
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-4047
Practice Address - Country:US
Practice Address - Phone:619-740-9700
Practice Address - Fax:619-486-8446
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND949175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath