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General NPI Number Information
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NPI Number | 1285515312
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Entity Type | Individual
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Provider Name | MARIO RUIZ
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Gender | Male
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 324 F ST
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City | EUREKA
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State | CA
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Zip | 95501-1006
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Country | US
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Telephone | 707-440-4577
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Fax |
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Provider Business Mailing Address
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Address Line | 40 HILLTOP DR STE C
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City | REDDING
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State | CA
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Zip | 96003-2806
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Country | US
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Telephone | 530-932-2447
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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