Healthcare Provider Details

I. General information

NPI: 1225975675
Provider Name (Legal Business Name): TANIA RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N PALM CANYON DR STE A1-A4
PALM SPRINGS CA
92262-1868
US

IV. Provider business mailing address

51640 IDA AVE
CABAZON CA
92230-5102
US

V. Phone/Fax

Practice location:
  • Phone: 760-424-5602
  • Fax:
Mailing address:
  • Phone: 909-801-0787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: