Provider Demographics
NPI:1215750476
Name:RUIZ-BERMUDEZ, MELISSA MICHELLE
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MICHELLE
Last Name:RUIZ-BERMUDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 N MAIN ST STE 152
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-3013
Mailing Address - Country:US
Mailing Address - Phone:760-878-8374
Mailing Address - Fax:
Practice Address - Street 1:550 SOUTH CLAY STREET
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:CA
Practice Address - Zip Code:93526
Practice Address - Country:US
Practice Address - Phone:760-872-2162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator