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Individual

MS. YAZMIN RUIZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPT

Contact information

Practice address
1901 CLEVELAND AVENUE, SUITE B, SANTA ROSA TREATMENT PROGRAM, SANTA ROSA, CA 95403
(707) 576-0818
Mailing address
1901 CLEVELAND AVENUE, SUITE B, SANTA ROSA TREATMENT PROGRAM, SANTA ROSA, CA 95403
(707) 576-0818
(707) 576-7845

Taxonomy

Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT37428
CA

Other

Enumeration date
09/03/2014
Last updated
09/03/2014
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