Provider Demographics
NPI:1710130182
Name:RUIZ, ARTURO HERNANDEZ (RECOVERY WORKER)
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:HERNANDEZ
Last Name:RUIZ
Suffix:
Gender:M
Credentials:RECOVERY WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 TURNBERRY TER
Mailing Address - Street 2:
Mailing Address - City:RIO VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:94571-2124
Mailing Address - Country:US
Mailing Address - Phone:707-425-1799
Mailing Address - Fax:707-425-1081
Practice Address - Street 1:706 TURNBERRY TER
Practice Address - Street 2:
Practice Address - City:RIO VISTA
Practice Address - State:CA
Practice Address - Zip Code:94571-2124
Practice Address - Country:US
Practice Address - Phone:707-425-1799
Practice Address - Fax:707-425-1081
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARW 2017101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA481002 02 120OtherDRIVING UNDER THE INFLUENCE PROGRAMS