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Individual

MRS. KRISTY ANNA RUIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
658 E BRIER DR, SAN BERNARDINO, CA 92408
(909) 501-0820
Mailing address
658 E BRIER DR, SAN BERNARDINO, CA 92408-2880
(909) 501-0820

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
NA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H5318
COUNTY OF SAN BERNARDINO
CA
01
NA
NA
Enumeration date
05/06/2019
Last updated
11/20/2019
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