Active NPI
Ivan Ruiz, PHD
- Clinical Psychologist
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY35734
- Practice address
- 740 Westwood PLZ Ste C8-222
Los Angeles, CA 90095-8353 - Phone
- (310) 206-9326
- NPI assigned
- Dec 9, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY35734 | CA | |
| Clinical Psychologist | 103TC0700X | PSY35734 | CA | Primary |
Addresses
Primary practice location
740 Westwood PLZ Ste C8-222
Los Angeles, CA 90095-8353
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Other practice location 1
12021 Wilmington Ave
Los Angeles, CA 90059-3019
Phone (310) 454-5043
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY35734 | CA | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| UC Regents | Clinical | Current | Accepting new patients |
Locations
300 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-8438
File 2939
Los Angeles, CA 90074
Phone (310) 794-6596
5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200
Organizations & group practices 1
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": "1733702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762387200000",
"number": "1346056884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD STE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "740 WESTWOOD PLZ STE C8-222",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900958353",
"telephone_number": "310-206-9326"
}
],
"practiceLocations": [
{
"address_1": "12021 Wilmington Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900593019",
"country_code": "US",
"telephone_number": "310-454-5043",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUIZ",
"first_name": "IVAN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-09",
"last_updated": "2025-11-06",
"certification_date": "2025-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "PSY35734",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY35734",
"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 Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.