Healthcare Provider Details

I. General information

NPI: 1134269582
Provider Name (Legal Business Name): MARIA RODRIGUEZ RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N 8TH ST
EL CENTRO CA
92243-2302
US

IV. Provider business mailing address

670 W WORTHINGTON RD
IMPERIAL CA
92251-9705
US

V. Phone/Fax

Practice location:
  • Phone: 442-265-7935
  • Fax:
Mailing address:
  • Phone: 442-230-4609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: