Individual provider Active NPI

Melissa Eilleen Ruano

  • Professional Counselor
  • San Diego, CA
National Provider Identifier
1194466409
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
APCC11729 Issued in CA
Practice address
5555 Reservoir Dr Ste 204-a
San Diego, CA 92120-5134
Phone
(619) 822-1800
Fax
(619) 839-3872
NPI assigned
Apr 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X APCC11729 CA Primary

Addresses

Primary practice location

5555 Reservoir Dr Ste 204-a
San Diego, CA 92120-5134

Mailing address

5555 Reservoir Dr Ste 204-a
San Diego, CA 92120-5134
Phone (619) 822-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814003863 CA Practitioner - Mental Health Counselor 9133628456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4508 3Rd St
Apt 29
La Mesa, CA 91941-5563

9465 Farnham St
San Diego, CA 92123-1308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APCC11729CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Systems, Inc. CurrentSince Jun 16, 2025 Accepting new patients
Mental Health Systems, Inc. Current Accepting new patients
Community Research Foundation Inc PastSince Apr 1, 2022 Accepting new patients
Mental Health Systems, Inc. PastSince Mar 5, 2023 Accepting new patients

Locations

5555 Reservoir Dr
#204A
San Diego, CA 92120
Phone (619) 822-1800

9465 Farnham St
San Diego, CA 92123
Phone (858) 576-4311

Organizations & group practices 4

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": "1648857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1194466409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR STE 204-A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205134",
            "telephone_number": "619-822-1800",
            "fax_number": "619-839-3872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR STE 204-A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205134",
            "telephone_number": "619-822-1800",
            "fax_number": "619-839-3872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUANO",
        "first_name": "MELISSA",
        "middle_name": "EILLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-02",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "APCC11729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.