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General NPI Number Information
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NPI Number | 1114837903
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Entity Type | Individual
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Provider Name | MARBELLA ALEJANDRA RUIZ CASTRO QMHA
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Gender | Female
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 955 TOWN CENTRE DR STE C
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City | MEDFORD
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State | OR
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Zip | 97504-6188
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Country | US
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Telephone | 458-226-6282
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Fax | 541-200-6151
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Provider Business Mailing Address
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Address Line | 2762 HIGH CEDARS LN
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City | MEDFORD
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State | OR
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Zip | 97504-3416
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Country | US
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Telephone | 458-226-6282
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Fax | 541-200-6151
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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