Healthcare Provider Details

I. General information

NPI: 1518602572
Provider Name (Legal Business Name): RUTH ELIZABETH AGUIRRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 S COAST HWY # 2862
LAGUNA BEACH CA
92651-3681
US

IV. Provider business mailing address

1968 S COAST HWY # 2862
LAGUNA BEACH CA
92651-3681
US

V. Phone/Fax

Practice location:
  • Phone: 562-444-2853
  • Fax: 562-683-0303
Mailing address:
  • Phone: 562-444-2853
  • Fax: 562-683-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: