Provider Demographics
NPI:1528390879
Name:RUIZ, LORRAINE MICHELLE (SPA #200)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:MICHELLE
Last Name:RUIZ
Suffix:
Gender:F
Credentials:SPA #200
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8742 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2238
Mailing Address - Country:US
Mailing Address - Phone:562-519-4972
Mailing Address - Fax:
Practice Address - Street 1:8742 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2238
Practice Address - Country:US
Practice Address - Phone:562-519-4972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA #2002355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant