Provider Demographics
NPI:1821252644
Name:RUIZ-LLAMAS, MARLENE (BA)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:RUIZ-LLAMAS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 N ARROWHEAD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401-1251
Mailing Address - Country:US
Mailing Address - Phone:951-500-6124
Mailing Address - Fax:909-266-2710
Practice Address - Street 1:572 N ARROWHEAD AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1251
Practice Address - Country:US
Practice Address - Phone:951-500-6124
Practice Address - Fax:909-266-2710
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor