Provider Demographics
NPI:1851757918
Name:WUNDERLEY, RUTH LEANNE BARIONI (CTRS)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:LEANNE BARIONI
Last Name:WUNDERLEY
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:LEANNE
Other - Last Name:BARIONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CTRS
Mailing Address - Street 1:21732 S VERMONT AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2180
Mailing Address - Country:US
Mailing Address - Phone:213-269-0622
Mailing Address - Fax:
Practice Address - Street 1:21732 S VERMONT AVE STE 210
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2180
Practice Address - Country:US
Practice Address - Phone:310-781-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53183172V00000X, 225400000X, 225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
No172V00000XOther Service ProvidersCommunity Health Worker
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner