Provider Demographics
NPI:1275349524
Name:RUIZ, DIANA KAY
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:KAY
Last Name:RUIZ
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 1:250 ATKINSON AVE
Mailing Address - Street 2:
Mailing Address - City:SHAFTER
Mailing Address - State:CA
Mailing Address - Zip Code:93263-2508
Mailing Address - Country:US
Mailing Address - Phone:661-477-3626
Mailing Address - Fax:
Practice Address - Street 1:1627 S GARDEN ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4949
Practice Address - Country:US
Practice Address - Phone:661-477-3626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator