Provider Demographics
NPI:1295359347
Name:RUIZ, LESLIE JANET
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:JANET
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 1:2371 MYRTLE RD APT 208
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-8503
Mailing Address - Country:US
Mailing Address - Phone:760-693-7356
Mailing Address - Fax:
Practice Address - Street 1:2371 MYRTLE RD APT 208
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-8503
Practice Address - Country:US
Practice Address - Phone:760-693-7356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other