Provider Demographics
NPI:1295081271
Name:RUIZ, AIMEE (LAC)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 ELWOOD AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-1947
Mailing Address - Country:US
Mailing Address - Phone:415-200-7479
Mailing Address - Fax:
Practice Address - Street 1:495 ELWOOD AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-1947
Practice Address - Country:US
Practice Address - Phone:415-200-7479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14804171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist