Provider Demographics
NPI:1679346548
Name:RUIZ, ALISHA CHRISTINE (NP)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:CHRISTINE
Last Name:RUIZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14346 BRIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-2001
Mailing Address - Country:US
Mailing Address - Phone:562-682-1585
Mailing Address - Fax:
Practice Address - Street 1:12214 LAKEWOOD BLVD STE 110
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2663
Practice Address - Country:US
Practice Address - Phone:562-862-2775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026980363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily