Healthcare Provider Details

I. General information

NPI: 1124852926
Provider Name (Legal Business Name): RUYA URSO COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 S BAKER ST
SANTA ANA CA
92707-3825
US

IV. Provider business mailing address

3401 S BAKER ST
SANTA ANA CA
92707-3825
US

V. Phone/Fax

Practice location:
  • Phone: 949-293-5856
  • Fax:
Mailing address:
  • Phone: 949-293-5856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. RUYA URSO
Title or Position: PRESIDENT
Credential: M.A., LMFT
Phone: 949-293-5856