Individual provider Active NPI

Keisha Ruiz, RN, PHN

  • Registered Nurse
  • Indio, CA
National Provider Identifier
1386401545
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95364626 Issued in CA
Practice address
47915 Oasis St
Indio, CA 92201-6950
Phone
(760) 863-8650
NPI assigned
Mar 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95364626 CA Primary

Addresses

Primary practice location

47915 Oasis St
Indio, CA 92201-6950

Mailing address

40512 Alabama Hills Dr
Indio, CA 92203-3891
Phone (760) 625-6245

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95364626CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1386401545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40512 ALABAMA HILLS DR",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922033891",
            "telephone_number": "760-625-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47915 OASIS ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922016950",
            "telephone_number": "760-863-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "KEISHA",
        "credential": "RN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95364626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.

Verify at the official NPI Registry.