Provider Demographics
NPI:1275289688
Name:RUIZ, CYNTHIA DANIELLE (COTA)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DANIELLE
Last Name:RUIZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8344 CLAIREMONT MESA BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1327
Mailing Address - Country:US
Mailing Address - Phone:858-565-6910
Mailing Address - Fax:
Practice Address - Street 1:8344 CLAIREMONT MESA BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1327
Practice Address - Country:US
Practice Address - Phone:858-565-6910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5407224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant