Lequarius Ruttlen

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

12021 Wilmington Ave
Los Angeles, CA 90059

Phone

(310) 454-5043

NPI assigned

May 13, 2016

Last updated

Aug 30, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1316393887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8314 COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900013918",
            "telephone_number": "310-667-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 WILMINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90059",
            "telephone_number": "310-454-5043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9808 Venice Blvd",
            "address_2": "Ste. 505",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902322732",
            "country_code": "US",
            "telephone_number": "310-945-3350",
            "fax_number": "310-945-3356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTTLEN",
        "first_name": "LEQUARIUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-13",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "103536",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roxanne Ruther, PT, DPT
• Frederick C Rutherford, DDS
• Rose Rutherford
• Julia X Rutkouskaya, PHARMD
• Carol A Rutledge
• Karina Ruvalcaba Limon
• Angelica Ruvalcaba
• Catalina Ruvalcaba
• Diana Ruvalcaba
• Ely Ruvalcaba

• Student in an Organized Health Care Education/Training Program in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.