Healthcare Provider Details

I. General information

NPI: 1912467440
Provider Name (Legal Business Name): BRITTNEY RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 11/16/2021
Certification Date: 11/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9864 BALDWIN PL
EL MONTE CA
91731-2202
US

IV. Provider business mailing address

9864 BALDWIN PL
EL MONTE CA
91731-2202
US

V. Phone/Fax

Practice location:
  • Phone: 626-528-1103
  • Fax:
Mailing address:
  • Phone: 626-528-1103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code167G00000X
TaxonomyLicensed Psychiatric Technician
License Number41150
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: