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NPI Code Detail

MEDICARE: MS. MICHELLE RUIZ AMFT

MEDICARE: MS. MICHELLE RUIZ AMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1528715406
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE RUIZ AMFT
Provider Business Mailing Address
First Line : 170 S OAKLAND AVE
Second Line :
City : PASADENA
State : CA
Zip : 91101-2561
Country : US
Telephone Number : 818-247-7474
Fax Number :
Provider Business Practice Location Address
First Line : 170 S OAKLAND AVE
Second Line :
City : PASADENA
State : CA
Zip : 91101-2561
Country : US
Telephone Number : 818-247-7474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2022
Last Update Date : 03/09/2022

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