Provider Demographics
NPI:1780426668
Name:VELASQUEZ, RUTH NOEMI
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:NOEMI
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21732 S VERMONT AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2180
Mailing Address - Country:US
Mailing Address - Phone:310-781-3400
Mailing Address - Fax:
Practice Address - Street 1:21732 S VERMONT AVE STE 210
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2180
Practice Address - Country:US
Practice Address - Phone:310-781-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No172V00000XOther Service ProvidersCommunity Health Worker