Richard Rustanto, MSN, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

95051858 Issued in CA

Practice address

1600 W Beverly Blvd
Montebello, CA 90640-3932

Phone

(323) 887-1313

NPI assigned

May 24, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1780259515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 SUNRISE WAY",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917677014",
            "telephone_number": "818-585-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403932",
            "telephone_number": "323-887-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTANTO",
        "first_name": "RICHARD",
        "credential": "MSN, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95051858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rrustanto@dhs.lacounty.gov",
            "affiliation": "N",
            "endpointDescription": "DHS email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1600 W Beverly Blvd",
            "city": "Montebello",
            "state": "CA",
            "country_code": "US",
            "postal_code": "906403932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Michelle Elizabeth Ruiz
• Ravin Manu Rupani, M.D.
• S. Ghazarian DDS., Inc.
• Nicole Lee Saenz
• Richard Kiyoshi Sahara, D.D.S.
• Ronald Riyochi Sahara, D.D.S.
• Ebrahim Sajedi, MD

• Psychiatric/Mental Health Registered Nurse in Montebello, CA
• Providers in Montebello, CA by specialty
• Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.