Provider Demographics
NPI:1679128987
Name:RUIZ, VERONICA MARIA (RN, PHN)
Entity type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:MARIA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7917 EISENHOWER ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2476
Mailing Address - Country:US
Mailing Address - Phone:805-216-2448
Mailing Address - Fax:
Practice Address - Street 1:4651 TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-8779
Practice Address - Country:US
Practice Address - Phone:805-654-5536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-04
Last Update Date:2019-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACARN464591163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health