Healthcare Provider Details

I. General information

NPI: 1376974550
Provider Name (Legal Business Name): ESMERALDA RUIZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2013
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 B ST
LIVINGSTON CA
95334-9593
US

IV. Provider business mailing address

600 B ST
LIVINGSTON CA
95334-9593
US

V. Phone/Fax

Practice location:
  • Phone: 209-850-3500
  • Fax:
Mailing address:
  • Phone: 209-850-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW138049
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: