Provider Demographics
NPI:1154820819
Name:RUIZ, MONICA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10140 CAMPUS POINT DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1520
Mailing Address - Country:US
Mailing Address - Phone:858-678-7049
Mailing Address - Fax:858-678-7091
Practice Address - Street 1:10140 CAMPUS POINT DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1520
Practice Address - Country:US
Practice Address - Phone:858-678-7049
Practice Address - Fax:858-678-7091
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator