Individual provider Active NPI

Cristal Ruiz Campos

  • Mental Health Counselor
  • San Jose, CA
National Provider Identifier
1295395275
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
88781 Issued in CA
Practice address
232 E Gish Rd
San Jose, CA 95112-4706
Phone
(408) 876-4284
NPI assigned
Jun 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Mental Health Counselor 101YM0800X 88781 CA Primary

Addresses

Primary practice location

232 E Gish Rd
San Jose, CA 95112-4706

Mailing address

232 E Gish Rd
San Jose, CA 95112-4706
Phone (408) 876-4284

Other practice location 1

9015 Murray Ave Ste 100
Gilroy, CA 95020-3617
Phone (408) 665-4908

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
88781CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1295395275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 E GISH RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951124706",
            "telephone_number": "408-876-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 E GISH RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951124706",
            "telephone_number": "408-876-4284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9015 Murray Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Gilroy",
            "state": "CA",
            "postal_code": "950203617",
            "country_code": "US",
            "telephone_number": "408-665-4908",
            "fax_number": "408-842-0383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ CAMPOS",
        "first_name": "CRISTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "88781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.