Healthcare Provider Details

I. General information

NPI: 1356884795
Provider Name (Legal Business Name): RUTH Z. PERRY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2016
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 W COLE BLVD
CALEXICO CA
92231-9722
US

IV. Provider business mailing address

852 E DANENBERG DR
EL CENTRO CA
92243-8517
US

V. Phone/Fax

Practice location:
  • Phone: 760-357-2020
  • Fax: 760-357-1056
Mailing address:
  • Phone: 760-344-9951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number235703
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: