Active NPI
Elizabeth Ilianna Ruiz
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1124504246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 115354
- Practice address
- 4717 McKinley Ave
Los Angeles, CA 90011-5420 - Phone
- (626) 596-0373
- NPI assigned
- Jul 11, 2018
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 89836 | CA | |
| Social Worker | 104100000X | 89836 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 115354 | CA | Primary |
Addresses
Primary practice location
4717 McKinley Ave
Los Angeles, CA 90011-5420
Mailing address
PO Box 811104
Los Angeles, CA 90081-0002
Phone (626) 596-0373
Other practice location 1
4620 Oak St
Pico Rivera, CA 90660-2246
Phone (626) 596-0373
Other practice location 2
1233 S La Cienega Blvd
Los Angeles, CA 90035-2520
Phone (310) 855-0031
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89836 | CA | MD | Mental Health Counselor |
| 115354 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1124504246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 811104",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900810002",
"telephone_number": "626-596-0373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4717 MCKINLEY AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900115420",
"telephone_number": "626-596-0373"
}
],
"practiceLocations": [
{
"address_1": "4620 Oak St",
"address_purpose": "LOCATION",
"city": "Pico Rivera",
"state": "CA",
"postal_code": "906602246",
"country_code": "US",
"telephone_number": "626-596-0373",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1233 S La Cienega Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900352520",
"country_code": "US",
"telephone_number": "310-855-0031",
"fax_number": "310-751-5422",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUIZ",
"first_name": "ELIZABETH",
"middle_name": "ILIANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-11",
"last_updated": "2024-10-15",
"certification_date": "2024-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "89836",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "89836",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "115354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.