Provider Demographics
NPI:1700402328
Name:RUIZ-NANEZ, ROSALBA A
Entity Type:Individual
Prefix:
First Name:ROSALBA
Middle Name:A
Last Name:RUIZ-NANEZ
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 1:10 CARR ST
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-4710
Mailing Address - Country:US
Mailing Address - Phone:831-419-9006
Mailing Address - Fax:831-288-0035
Practice Address - Street 1:10 CARR ST
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-4710
Practice Address - Country:US
Practice Address - Phone:831-419-9006
Practice Address - Fax:831-288-0035
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator