Provider Demographics
NPI:1952191728
Name:RUIZ-STEPHENS, CRISTINA (PSYD)
Entity type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:
Last Name:RUIZ-STEPHENS
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:RUIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:2345 MORGAN FARM DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-3044
Mailing Address - Country:US
Mailing Address - Phone:203-558-9080
Mailing Address - Fax:
Practice Address - Street 1:455 PHILIP BLVD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-8767
Practice Address - Country:US
Practice Address - Phone:678-225-0350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID8771253103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical