Individual
HALEY RUSTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
564 MOUNTAIN RANCH RD # 5, SAN ANDREAS, CA 95249-9782
(209) 498-2227
Mailing address
PO BOX 1629, SAN ANDREAS, CA 95249-1629
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
01/30/2025
Last updated
03/12/2026
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