Individual provider Active NPI

Christian Ruiz

  • Peer Specialist
  • Half Moon Bay, CA
National Provider Identifier
1639599392
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
225 Cabrillo Hwy S Ste 200a
Half Moon Bay, CA 94019-7210
Phone
(650) 573-3724
NPI assigned
Apr 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Community Health Worker 172V00000X CA
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

225 Cabrillo Hwy S Ste 200a
Half Moon Bay, CA 94019-7210

Mailing address

957 Industrial Rd
Suite B
San Carlos, CA 94070-4151
Phone (650) 832-6914

Other practice location 1

957 Industrial Rd
suite B
San Carlos, CA 94070-4151
Phone (650) 832-6914

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": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1639599392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 INDUSTRIAL RD",
            "address_2": "SUITE B",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940704151",
            "telephone_number": "650-832-6914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CABRILLO HWY S STE 200A",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940197210",
            "telephone_number": "650-573-3724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "957 Industrial Rd",
            "address_2": "suite B",
            "address_purpose": "LOCATION",
            "city": "San Carlos",
            "state": "CA",
            "postal_code": "940704151",
            "country_code": "US",
            "telephone_number": "650-832-6914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "CHRISTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-21",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Half Moon Bay, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.