Provider Demographics
NPI:1316798002
Name:RUIZ, EMMA (MSW , PPSC)
Entity type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:MSW , PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20185 SAN MIGUEL AVE
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4209
Mailing Address - Country:US
Mailing Address - Phone:510-537-1919
Mailing Address - Fax:
Practice Address - Street 1:20185 SAN MIGUEL AVE
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4209
Practice Address - Country:US
Practice Address - Phone:510-537-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA689741041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool