Healthcare Provider Details

I. General information

NPI: 1447934062
Provider Name (Legal Business Name): KAMRYN RENE RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 5TH ST
SAN FRANCISCO CA
94107-1536
US

IV. Provider business mailing address

2703 TURK BLVD
SAN FRANCISCO CA
94118-4345
US

V. Phone/Fax

Practice location:
  • Phone: 415-995-1705
  • Fax: 415-348-8860
Mailing address:
  • Phone: 805-338-4630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number149780
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: