Provider Demographics
NPI:1407664923
Name:RUIZ HERNANDEZ, JOCELYN
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:RUIZ HERNANDEZ
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 1:1030 ALTURAS AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-2605
Mailing Address - Country:US
Mailing Address - Phone:530-280-1386
Mailing Address - Fax:
Practice Address - Street 1:580 W 5TH ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4407
Practice Address - Country:US
Practice Address - Phone:775-786-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker