Healthcare Provider Details

I. General information

NPI: 1487783205
Provider Name (Legal Business Name): JENNIFER RUIZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER LAPIDARIO RUIZ LAPIDARIO LCSW

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9018 BALBOA BLVD # 143
NORTHRIDGE CA
91325-2610
US

IV. Provider business mailing address

9018 BALBOA BLVD # 143
NORTHRIDGE CA
91325-2610
US

V. Phone/Fax

Practice location:
  • Phone: 310-228-8221
  • Fax: 818-781-9628
Mailing address:
  • Phone: 310-228-8221
  • Fax: 310-228-8221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number25111
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: