Healthcare Provider Details

I. General information

NPI: 1689584385
Provider Name (Legal Business Name): RALPH JOHN CRUZ SANTOS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9489 E STONEHAVEN WAY
TUCSON AZ
85747-9285
US

IV. Provider business mailing address

9489 E STONEHAVEN WAY
TUCSON AZ
85747-9285
US

V. Phone/Fax

Practice location:
  • Phone: 773-606-9619
  • Fax:
Mailing address:
  • Phone: 773-606-9619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number235738
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: