Provider Demographics
NPI:1134755473
Name:ALANIS RUIZ, GUADALUPE LIZBETH
Entity type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:LIZBETH
Last Name:ALANIS RUIZ
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 1:16501 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2007
Mailing Address - Country:US
Mailing Address - Phone:818-356-8106
Mailing Address - Fax:
Practice Address - Street 1:23450 NEWHALL AVE SPC 61
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-3138
Practice Address - Country:US
Practice Address - Phone:661-753-4224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician