Healthcare Provider Details

I. General information

NPI: 1821922162
Provider Name (Legal Business Name): ERIC CRUZ MS, PPSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E MISSION HILLS CT
SAN MARCOS CA
92069-1965
US

IV. Provider business mailing address

1 E MISSION HILLS CT
SAN MARCOS CA
92069-1965
US

V. Phone/Fax

Practice location:
  • Phone: 760-290-2748
  • Fax: 760-290-2685
Mailing address:
  • Phone: 760-290-2748
  • Fax: 760-290-2685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number240064543
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: