Individual provider Active NPI

Ryorayne Ruby Agcopra Gonzales

  • Registered Nurse
  • Mather, CA
National Provider Identifier
1326911082
Registry record updated Sep 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95159417 Issued in CA
Practice address
10535 Hospital Way
Mather, CA 95655-4200
Phone
(800) 382-8387
NPI assigned
Sep 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95159417 CA Primary

Addresses

Primary practice location

10535 Hospital Way
Mather, CA 95655-4200

Mailing address

950 S Garfield St Apt 39
Lodi, CA 95240-5446
Phone (727) 336-9685

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

State licenses

LicenseStateTypeSpecialty
95159417CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1758931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758931200000",
    "number": "1326911082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S GARFIELD ST APT 39",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405446",
            "telephone_number": "727-336-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 HOSPITAL WAY",
            "city": "MATHER",
            "state": "CA",
            "postal_code": "956554200",
            "telephone_number": "800-382-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "RYORAYNE RUBY",
        "middle_name": "AGCOPRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-27",
        "last_updated": "2025-09-27",
        "certification_date": "2025-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95159417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mather, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2025; 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.