Active NPI
Johanna Ruiz, RN, PHN, MSN
- Registered Nurse
- Lakeport, CA
National Provider Identifier
1669862033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 848441
- Practice address
- 922 Bevins CT
Lakeport, CA 95453-9754 - Phone
- (707) 263-1090
- NPI assigned
- Jan 23, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 848441 | CA | Primary |
Addresses
Primary practice location
922 Bevins CT
Lakeport, CA 95453-9754
Mailing address
922 Bevins CT
Lakeport, CA 95453-9754
Phone (707) 263-1090
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
- Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 848441 | CA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake County Health Services Department | Past | Accepting new patients | |
| County of Lake Public Health Department | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Public Health or Welfare Agency
- Clearlake, CA
- NPI 1396807459
-
- Public Health or Welfare Agency
- Lakeport, CA
- NPI 1104859347
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421971200000",
"number": "1669862033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "922 BEVINS CT",
"city": "LAKEPORT",
"state": "CA",
"postal_code": "954539754",
"telephone_number": "707-263-1090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "922 BEVINS CT",
"city": "LAKEPORT",
"state": "CA",
"postal_code": "954539754",
"telephone_number": "707-263-1090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUIZ",
"first_name": "JOHANNA",
"credential": "RN, PHN, MSN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-23",
"last_updated": "2015-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "848441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeport, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.