Mario Ruiz, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95030403 Issued in CA

Practice address

675 W Foothill Blvd Ste 200
Claremont, CA 91711-3475

Phone

(925) 282-1778

NPI assigned

Nov 21, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pacific Coast Psychiatric Associates Inc

  dba Lifestance Health

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465

  CA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1386469427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 W WEST COVINA PKWY # 477",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902810",
            "telephone_number": "323-947-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W FOOTHILL BLVD STE 200",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113475",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1004 W West Covina Pkwy # 477",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917902810",
            "country_code": "US",
            "telephone_number": "626-597-8670",
            "fax_number": "626-608-0501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7500 Hellman Ave",
            "address_purpose": "LOCATION",
            "city": "Rosemead",
            "state": "CA",
            "postal_code": "917702216",
            "country_code": "US",
            "telephone_number": "323-947-1167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "MARIO",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-21",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95214650",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95030403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosedove Inc (Serenity Hospice Care)
• Erica Florence Rosenfeld, PH.D.
• Alicia Roth, PA
• Jeanne M Roy, M.A., M.F.T.
• Stephanie J Rubi
• S Acupuncture
• Andrea Saavedra-Metoyer
• Saad Faiz Bahjat Sagman, D.D.S.
• Sahawneh Dental Corporation (Bright Now Dental - Claremont)
• Saint James Integrated Health, LLC

• Psychiatric/Mental Health Nurse Practitioner in Claremont, CA
• Providers in Claremont, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.

Verify at the official NPI Registry.