Provider Demographics
NPI:1023147048
Name:RUFUS, DERRICK C (PSYD)
Entity type:Individual
Prefix:
First Name:DERRICK
Middle Name:C
Last Name:RUFUS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 TRUXTUN AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-4700
Mailing Address - Country:US
Mailing Address - Phone:661-398-2981
Mailing Address - Fax:
Practice Address - Street 1:701 SCOFIELD AVE
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280-7515
Practice Address - Country:US
Practice Address - Phone:661-758-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA618501041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical