Healthcare Provider Details

I. General information

NPI: 1366319196
Provider Name (Legal Business Name): EVELYN RUELAS GARCIA M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 CLARICE DR
SAN JOSE CA
95122-1204
US

IV. Provider business mailing address

1290 RIDDER PARK DR
SAN JOSE CA
95131-2304
US

V. Phone/Fax

Practice location:
  • Phone: 408-270-6751
  • Fax:
Mailing address:
  • Phone:
  • Fax: 408-453-4231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number6CDEA8B619
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: