Provider Demographics
NPI:1669887857
Name:RUIZ-OCHOA, CARMEN MARIA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:MARIA
Last Name:RUIZ-OCHOA
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:CARMEN
Other - Middle Name:MARIA
Other - Last Name:RUIZ DE MARQUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:25620 REED DR
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-2403
Mailing Address - Country:US
Mailing Address - Phone:310-210-1973
Mailing Address - Fax:
Practice Address - Street 1:6101 W CENTINELA AVE STE 380
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6367
Practice Address - Country:US
Practice Address - Phone:310-337-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-15224103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst