Active NPI
Kristy Anna Ruiz
- Peer Specialist
- San Bernardino, CA
National Provider Identifier
1003471079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- NA
- Practice address
- 658 E Brier Dr
San Bernardino, CA 92408 - Phone
- (909) 501-0820
- NPI assigned
- May 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | NA | Primary |
Addresses
Primary practice location
658 E Brier Dr
San Bernardino, CA 92408
Mailing address
658 E Brier Dr
San Bernardino, CA 92408-2880
Phone (909) 501-0820
Other practice location 1
658 E Brier Dr
San Bernardino, CA 92408
Phone (909) 501-0820
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA | |
| H5318 | Other | CA | COUNTY OF SAN BERNARDINO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574208000000",
"number": "1003471079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "658 E BRIER DR",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924082880",
"telephone_number": "909-501-0820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "658 E BRIER DR",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "92408",
"telephone_number": "909-501-0820"
}
],
"practiceLocations": [
{
"address_1": "658 E Brier Dr",
"address_purpose": "LOCATION",
"city": "San Bernardino",
"state": "CA",
"postal_code": "92408",
"country_code": "US",
"telephone_number": "909-501-0820",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUIZ",
"first_name": "KRISTY",
"middle_name": "ANNA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-06",
"last_updated": "2019-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": "NA",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COUNTY OF SAN BERNARDINO",
"identifier": "H5318",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.