Provider Demographics
NPI:1033932538
Name:RUIZ, MARIA REBECCA (PPS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:REBECCA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 N CLOVERDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLOVERDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95425-3324
Mailing Address - Country:US
Mailing Address - Phone:707-894-1900
Mailing Address - Fax:
Practice Address - Street 1:509 N CLOVERDALE BLVD
Practice Address - Street 2:
Practice Address - City:CLOVERDALE
Practice Address - State:CA
Practice Address - Zip Code:95425-3324
Practice Address - Country:US
Practice Address - Phone:707-894-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool