Individual
MRS. JENNIE LE RUIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-BC
Contact information
Practice address
12001 NIETA DR, GARDEN GROVE, CA 92840-3523
(714) 702-0090
Mailing address
12522 LAMBERT RD, WHITTIER, CA 90606-2758
(562) 967-2273
(562) 967-2911
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95003804
CA
363LA2200X
Adult Health Nurse Practitioner
95003804
CA
363LG0600X
Gerontology Nurse Practitioner
95003804
CA
Other
Enumeration date
01/19/2017
Last updated
11/03/2021
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