Provider Demographics
NPI:1053598300
Name:RAYS, BRUCE (PSYD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:
Last Name:RAYS
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 1:23410 CIVIC CENTER WAY
Mailing Address - Street 2:SUITE E-8
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-5909
Mailing Address - Country:US
Mailing Address - Phone:310-457-1210
Mailing Address - Fax:
Practice Address - Street 1:23410 CIVIC CENTER WAY
Practice Address - Street 2:SUITE E-8
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-5909
Practice Address - Country:US
Practice Address - Phone:310-457-1210
Practice Address - Fax:310-456-8838
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY-16812103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical