Organization Active NPI

Raymond S. Ruzicano, M.D.Inc

  • Psychiatry Physician
  • Walnut Creek, CA
National Provider Identifier
1023367398
Registry record updated Sep 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G33140 Issued in CA
Legal business name
RAYMOND S. RUZICANO, M.D.INC
Practice address
112 La Casa Via
Suite 345
Walnut Creek, CA 94598-3091
Phone
(925) 943-1400
NPI assigned
Sep 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Raymondr S Ruzicano, MD
Title
Owner
Phone
(925) 943-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X G33140 CA Primary

Addresses

Primary practice location

112 La Casa Via
Suite 345
Walnut Creek, CA 94598-3091

Mailing address

112 La Casa Via
Suite 345
Walnut Creek, CA 94598-3091
Phone (925) 943-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121116000059 CA Part B Supplier - Clinic/Group Practice 0143471318 Receives reassigned benefits from 1 practitioner
Practice locations: Walnut Creek, CA

National Provider Directory

National Provider Directory

Locations

112 La Casa Via
Ste 345
Walnut Creek, CA 94598
Phone (925) 943-1400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346544000000",
    "number": "1023367398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LA CASA VIA",
            "address_2": "SUITE 345",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983091",
            "telephone_number": "925-943-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LA CASA VIA",
            "address_2": "SUITE 345",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983091",
            "telephone_number": "925-943-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND S. RUZICANO, M.D.INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-02",
        "last_updated": "2012-09-02",
        "status": "A",
        "authorized_official_last_name": "RUZICANO",
        "authorized_official_first_name": "RAYMONDR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-943-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G33140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.