Individual
MR. DERRICK RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CATC - III
Contact information
Practice address
3132 JEFFERSON ST, SAN DIEGO, CA 92110-4421
(619) 683-3100
Mailing address
8627 JUNIPER ST, LOS ANGELES, CA 90002-1539
(213) 248-0292
(833) 341-1107
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
CA
225400000X
Rehabilitation Practitioner
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
05/01/2020
Last updated
07/17/2026
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