Active NPI
Destiny Ruiz
- Behavior Technician
- San Bernardino, CA
National Provider Identifier
1306687447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 958 E 2ND St
San Bernardino, CA 92408-1271 - Phone
- (909) 674-7793
- NPI assigned
- Jun 3, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
958 E 2ND St
San Bernardino, CA 92408-1271
Mailing address
4401 Crenshaw Blvd Ste 215
Los Angeles, CA 90043-1200
Phone (323) 291-7100
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717372800000",
"number": "1306687447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4401 CRENSHAW BLVD STE 215",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900431200",
"telephone_number": "323-291-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "958 E 2ND ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924081271",
"telephone_number": "909-674-7793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUIZ",
"first_name": "DESTINY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-03",
"last_updated": "2024-06-03",
"certification_date": "2024-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.