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NPI Code Detail

MEDICARE: CHRISTIAN RUIZ

MEDICARE: CHRISTIAN RUIZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2172V00000XCommunity Health WorkerCA
3175T00000XPeer Specialist

General Provider Information

NPI Number : 1639599392
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN RUIZ
Provider Business Mailing Address
First Line : 957 INDUSTRIAL RD
Second Line : SUITE B
City : SAN CARLOS
State : CA
Zip : 94070-4151
Country : US
Telephone Number : 650-832-6914
Fax Number :
Provider Business Practice Location Address
First Line : 225 CABRILLO HWY S STE 200A
Second Line :
City : HALF MOON BAY
State : CA
Zip : 94019-7210
Country : US
Telephone Number : 650-573-3724
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2014
Last Update Date : 04/19/2023

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Directions to “ CHRISTIAN RUIZ ” Practice Location

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