Provider Demographics
NPI:1366321184
Name:STORRUSTE, CAROLYN JEAN
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JEAN
Last Name:STORRUSTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 SUNSET PL
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-4006
Mailing Address - Country:US
Mailing Address - Phone:442-477-0071
Mailing Address - Fax:
Practice Address - Street 1:1141 CHELSEA ST
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-3208
Practice Address - Country:US
Practice Address - Phone:442-477-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist