Individual provider Active NPI

Brenda Ruiz, SLP

  • Occupational Therapy Assistant
  • Huntington Beach, CA
National Provider Identifier
1366080251
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA5086 Issued in CA
Practice address
7812 Edinger Ave Ste 400
Huntington Beach, CA 92647-3727
Phone
(714) 916-0641
Fax
(866) 806-1080
NPI assigned
Dec 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X OTA5086 CA Primary

Addresses

Primary practice location

7812 Edinger Ave Ste 400
Huntington Beach, CA 92647-3727

Mailing address

7812 Edinger Ave Ste 400
Huntington Beach, CA 92647-3727
Phone (714) 916-0641

Other identifiers 1

IdentifierTypeStateIssuer
OTA5086OtherCALICENSE

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
OTA5086CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Speech Services Multi-Specialty PastSince Dec 15, 2019 Accepting new patients

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": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1366080251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7812 EDINGER AVE STE 400",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473727",
            "telephone_number": "714-916-0641",
            "fax_number": "866-806-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7812 EDINGER AVE STE 400",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473727",
            "telephone_number": "714-916-0641",
            "fax_number": "866-806-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "BRENDA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA5086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "OTA5086",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.