Individual
DR. JENNA DERUBEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
16515 S 40TH ST STE 111, PHOENIX, AZ 85048-0559
(480) 706-2020
Mailing address
3911 W BUIST AVE, LAVEEN, AZ 85339-1251
(480) 330-1162
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-002424
AZ
152WC0802X
Corneal and Contact Management Optometrist
OPT-002424
AZ
152WP0200X
Pediatric Optometrist
OPT-002424
AZ
Other
Enumeration date
06/02/2020
Last updated
10/09/2024
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