Healthcare Provider Details

I. General information

NPI: 1720909120
Provider Name (Legal Business Name): ERIKA VANESSA RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7510 DE SOTO AVE
CANOGA PARK CA
91303-1430
US

IV. Provider business mailing address

15825 SATICOY ST APT 2
VAN NUYS CA
91406-3137
US

V. Phone/Fax

Practice location:
  • Phone: 818-716-5783
  • Fax:
Mailing address:
  • Phone: 818-383-5537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: