Individual provider Active NPI

David Jason Ruda, PHD

  • Counselor
  • Thousand Oaks, CA
National Provider Identifier
1104667559
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
13591 Issued in CA
Practice address
3170 Radcliffe Rd
Thousand Oaks, CA 91360-4619
Phone
(202) 538-9642
NPI assigned
May 31, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 13591 CA Primary

Addresses

Primary practice location

3170 Radcliffe Rd
Thousand Oaks, CA 91360-4619

Mailing address

3170 Radcliffe Rd
Thousand Oaks, CA 91360-4619
Phone (202) 538-9642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1104667559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 RADCLIFFE RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604619",
            "telephone_number": "202-538-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3170 RADCLIFFE RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604619",
            "telephone_number": "202-538-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDA",
        "first_name": "DAVID",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "13591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.