Provider Demographics
NPI:1306125059
Name:RUIZ, WILLIAM (PSY D)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:RUIZ
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB PONCE DE LEON
Mailing Address - Street 2:23 ST. 164
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4431
Mailing Address - Country:US
Mailing Address - Phone:787-426-1902
Mailing Address - Fax:787-788-0595
Practice Address - Street 1:URB. PONCE DE LEON 164 CALLE 23
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4431
Practice Address - Country:US
Practice Address - Phone:787-426-1902
Practice Address - Fax:787-788-0595
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3953103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical