Provider Demographics
NPI:1124477369
Name:RUIZ DE RODRIGUEZ, NORMA ELIZABETH (MA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:ELIZABETH
Last Name:RUIZ DE RODRIGUEZ
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 PARKMOOR AVE
Mailing Address - Street 2:#208
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3403
Mailing Address - Country:US
Mailing Address - Phone:408-234-7891
Mailing Address - Fax:
Practice Address - Street 1:1401 PARKMOOR AVE
Practice Address - Street 2:#208
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3403
Practice Address - Country:US
Practice Address - Phone:408-234-7891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11621789103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst