Individual provider Active NPI

Drucilla Ann Ruocco, PH.D.

  • Psychologist
  • San Diego, CA
National Provider Identifier
1730193681
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY15358 Issued in CA
Practice address
2423 Camino del Rio S Ste 205
San Diego, CA 92108-3735
Phone
(619) 283-2184
Fax
(619) 285-1938
NPI assigned
Jul 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY15358 CA Primary

Addresses

Primary practice location

2423 Camino del Rio S Ste 205
San Diego, CA 92108-3735

Mailing address

2423 Camino del Rio S Ste 205
San Diego, CA 92108-3735
Phone (619) 283-2184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050811000714 CA Practitioner - Clinical Psychologist 1951330752 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8885 Rio San Diego Dr
Suite 106
San Diego, CA 92108-1624
Phone (619) 283-2184

Ste
106 8885 Rio San Diego Dr
San Diego, CA 92108-1624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY15358CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730193681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 CAMINO DEL RIO S STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083735",
            "telephone_number": "619-283-2184",
            "fax_number": "619-285-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 CAMINO DEL RIO S STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083735",
            "telephone_number": "619-283-2184",
            "fax_number": "619-285-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUOCCO",
        "first_name": "DRUCILLA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY15358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.