Healthcare Provider Details

I. General information

NPI: 1649193541
Provider Name (Legal Business Name): NINSI RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 GATEWAY BLVD
SOUTH SAN FRANCISCO CA
94080-7017
US

IV. Provider business mailing address

900 CHESTNUT ST UNIT 319
REDWOOD CITY CA
94063-2693
US

V. Phone/Fax

Practice location:
  • Phone: 760-668-8879
  • Fax:
Mailing address:
  • Phone: 650-544-0598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: