Provider Demographics
NPI:1457688111
Name:DE LARIOS, RUTH ELLEN (RUTH DE LARIOS)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:ELLEN
Last Name:DE LARIOS
Suffix:
Gender:F
Credentials:RUTH DE LARIOS
Other - Prefix:DR
Other - First Name:RUTH
Other - Middle Name:ELLEN
Other - Last Name:DE LARIOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1068 S 7TH AVE
Mailing Address - Street 2:APT. 8
Mailing Address - City:AVENAL
Mailing Address - State:CA
Mailing Address - Zip Code:93204-1700
Mailing Address - Country:US
Mailing Address - Phone:559-386-0722
Mailing Address - Fax:
Practice Address - Street 1:1 KINGS WAY
Practice Address - Street 2:
Practice Address - City:AVENAL
Practice Address - State:CA
Practice Address - Zip Code:93204
Practice Address - Country:US
Practice Address - Phone:559-386-0388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)