Individual provider Active NPI

Jonathan Juarez-Ruiz

  • Marriage & Family Therapist
  • Citrus Heights, CA
National Provider Identifier
1043717416
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT130550 Issued in CA
Practice address
8421 Auburn Blvd Ste 3
Citrus Heights, CA 95610-0391
Phone
(916) 512-8420
NPI assigned
Apr 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Marriage & Family Therapist 106H00000X AMFT130550 CA Primary

Addresses

Primary practice location

8421 Auburn Blvd Ste 3
Citrus Heights, CA 95610-0391

Mailing address

1111 J St Apt 112
Davis, CA 95616-2162

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

State licenses

LicenseStateTypeSpecialty
AMFT130550CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Valley Indian Health Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1043717416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 J ST APT 112",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956162162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8421 AUBURN BLVD STE 3",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956100391",
            "telephone_number": "916-512-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ-RUIZ",
        "first_name": "JONATHAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT130550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.