Healthcare Provider Details

I. General information

NPI: 1962329730
Provider Name (Legal Business Name): DENNIS RYAN CRUZ RN, BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2900 E DEL MAR BLVD
PASADENA CA
91107-4375
US

IV. Provider business mailing address

2900 E DEL MAR BLVD
PASADENA CA
91107-4375
US

V. Phone/Fax

Practice location:
  • Phone: 626-823-2794
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95211825
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: