Provider Demographics
NPI:1134889835
Name:RUIZ, NADIA S (ACSW)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:S
Last Name:RUIZ
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-4940
Mailing Address - Country:US
Mailing Address - Phone:714-865-0922
Mailing Address - Fax:
Practice Address - Street 1:4631 HEDRICK AVE APT 118
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-1415
Practice Address - Country:US
Practice Address - Phone:714-865-0922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA961061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical