Provider Demographics
NPI:1447047568
Name:RUIZ, CHRISTIAN M CRUZ (CHW)
Entity type:Individual
Prefix:
First Name:CHRISTIAN M
Middle Name:CRUZ
Last Name:RUIZ
Suffix:
Gender:
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5571 CRESTLINE PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-2132
Mailing Address - Country:US
Mailing Address - Phone:909-714-8376
Mailing Address - Fax:
Practice Address - Street 1:407 E GILBERT ST STE 6
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-5325
Practice Address - Country:US
Practice Address - Phone:909-889-1136
Practice Address - Fax:909-889-2816
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker