Provider Demographics
NPI:1063078350
Name:THE NEST COUNSELING AND PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:THE NEST COUNSELING AND PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ-SHANK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:805-284-5337
Mailing Address - Street 1:PO BOX 481
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-0481
Mailing Address - Country:US
Mailing Address - Phone:805-284-5337
Mailing Address - Fax:
Practice Address - Street 1:27403 YNEZ RD STE 206
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-4616
Practice Address - Country:US
Practice Address - Phone:805-284-5337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty