Provider Demographics
NPI:1386511046
Name:NUNEZ VAZQUEZ, RUTH E (CPO)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:E
Last Name:NUNEZ VAZQUEZ
Suffix:
Gender:F
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 S STATE COLLEGE BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-5701
Mailing Address - Country:US
Mailing Address - Phone:714-844-2889
Mailing Address - Fax:714-844-2898
Practice Address - Street 1:1475 S STATE COLLEGE BLVD STE 112
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-5701
Practice Address - Country:US
Practice Address - Phone:714-844-2889
Practice Address - Fax:714-844-2898
Is Sole Proprietor?:No
Enumeration Date:2025-10-18
Last Update Date:2025-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPO05632222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist