Individual provider Active NPI

Fatima Y Zavala Ruiz, LCSW

  • Clinical Social Worker
  • Santa Cruz, CA
National Provider Identifier
1255176004
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
123103 Issued in CA
Practice address
East Cliff Family Health Center
1510 Capitola Rd
Santa Cruz, CA 95062
Phone
(831) 427-3500
NPI assigned
Jun 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 123103 CA Primary

Addresses

Primary practice location

East Cliff Family Health Center
1510 Capitola Rd
Santa Cruz, CA 95062

Mailing address

128 Viaduct Court
Santa Cruz, CA 95060
Phone (415) 297-9578

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
I20241002003155 CA Practitioner - Clinical Social Worker 1052842945 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123103CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Cruz Community Health Centers CurrentSince Jul 26, 2024 Accepting new patients
Santa Cruz Community Health Centers CurrentSince Jul 26, 2024 Accepting new patients

Locations

250 Locust St
Santa Cruz, CA 95060
Phone (831) 427-3582

Organizations & group practices 2

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": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1255176004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 VIADUCT COURT",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95060",
            "telephone_number": "415-297-9578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST CLIFF FAMILY HEALTH CENTER",
            "address_2": "1510 CAPITOLA RD",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95062",
            "telephone_number": "831-427-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVALA RUIZ",
        "first_name": "FATIMA",
        "middle_name": "Y",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "123103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.