Anthony C Rucker, MS

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSB94023171 Issued in CA

Practice address

13601 Whittier Blvd
Ste 310
Whittier, CA 90605-1902

Phone

(917) 754-3691

NPI assigned

Jan 15, 2017

Last updated

Jan 15, 2017By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Live Individuate Vibrate Evolve and Expand - Live

  • Community/Behavioral Health Agency
  • Pomona, CA
  • NPI 1043049182
  NPD Authorized official

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

{
    "created_epoch": "1484438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484438400000",
    "number": "1790221737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13601 WHITTIER BLVD",
            "address_2": "STE 310",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906051902",
            "telephone_number": "917-754-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13601 WHITTIER BLVD",
            "address_2": "STE 310",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906051902",
            "telephone_number": "917-754-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "ANTHONY",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-15",
        "last_updated": "2017-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSB94023171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Whittier, CA
• Providers in Whittier, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2017; 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.