Healthcare Provider Details

I. General information

NPI: 1154257343
Provider Name (Legal Business Name): EVELIN DIANA RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 E WALNUT ST
SANTA ANA CA
92701-5896
US

IV. Provider business mailing address

10506 GARFIELD AVE
SOUTH GATE CA
90280-7231
US

V. Phone/Fax

Practice location:
  • Phone: 213-855-3465
  • Fax:
Mailing address:
  • Phone: 323-348-7413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: