1124440763 NPI number — RUBY HILL MARRIAGE AND FAMILY COUNSELING CTR.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124440763 NPI number — RUBY HILL MARRIAGE AND FAMILY COUNSELING CTR.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RUBY HILL MARRIAGE AND FAMILY COUNSELING CTR.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THERAPY2THRIVE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124440763
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4460 BLACK AVE.
Provider Second Line Business Mailing Address:
STE. G.
Provider Business Mailing Address City Name:
PLEASANTON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94566-6139
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-426-1575
Provider Business Mailing Address Fax Number:
925-426-1575

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4460 BLACK AVE.
Provider Second Line Business Practice Location Address:
SUITE G
Provider Business Practice Location Address City Name:
PLEASANTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94566-6139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-426-1575
Provider Business Practice Location Address Fax Number:
925-426-1575
Provider Enumeration Date:
01/16/2014

Additional Information

Authorized Official

Authorized Official Last Name:
BAKER
Authorized Official First Name:
LESLIE
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
OWNER/EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
925-998-3392

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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