Provider Demographics
NPI:1881124436
Name:GARAY, RUDY ANDREW
Entity type:Individual
Prefix:
First Name:RUDY
Middle Name:ANDREW
Last Name:GARAY
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 1:8928 NEW DAWN DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-4022
Mailing Address - Country:US
Mailing Address - Phone:909-438-8536
Mailing Address - Fax:916-442-2525
Practice Address - Street 1:8928 NEW DAWN DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-4022
Practice Address - Country:US
Practice Address - Phone:909-438-8536
Practice Address - Fax:916-442-2525
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician