Healthcare Provider Details

I. General information

NPI: 1508576273
Provider Name (Legal Business Name): ARIANA JEZELLE RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2022
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S FREMONT AVE UNIT 7
ALHAMBRA CA
91803-8897
US

IV. Provider business mailing address

227 S CATALINA AVE UNIT 3
PASADENA CA
91106-5004
US

V. Phone/Fax

Practice location:
  • Phone: 626-457-4270
  • Fax:
Mailing address:
  • Phone: 909-532-2724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number035004
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: