Individual provider Active NPI

Desiree Ruiz, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1760151013
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023127063 Issued in CA
Practice address
7067 N Mariposa St Ste 103
Fresno, CA 93720-2988
Phone
(559) 380-4304
NPI assigned
Sep 9, 2021
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 720177 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023127063 CA Primary

Addresses

Primary practice location

7067 N Mariposa St Ste 103
Fresno, CA 93720-2988

Mailing address

7067 N Mariposa St Ste 103
Fresno, CA 93720-2988
Phone (559) 380-4304

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address desireer@ccbh-ag.com Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250416003384 CA Practitioner - Nurse Practitioner 8628593191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Coast Behavioral Health IncGroup PAC ID 6204356660, 14 clinicians

Practice addresses (Care Compare)

536 Camino Mercado
Arroyo Grande, CA 93420-1814
Phone (805) 540-0279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
720177CAMDRegistered Nurse
2023127063CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Desert Psychiatry Inc CurrentSince Feb 7, 2025 Accepting new patients
Central Coast Behavioral Health, Inc. Psychiatric/Mental Health CurrentSince Feb 7, 2025 Accepting new patients

Locations

536 Camino Mercado
Arroyo Grande, CA 93420
Phone (346) 502-3707

353 E Park Ave
El Cajon, CA 92020
Phone (323) 893-5844

7067 N Mariposa St
Ste 103
Fresno, CA 93720
Phone (559) 380-4304

74075 El Paseo
Ste A16
Palm Desert, CA 92260

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1760151013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7067 N MARIPOSA ST STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202988",
            "telephone_number": "559-380-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7067 N MARIPOSA ST STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202988",
            "telephone_number": "559-380-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "DESIREE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "720177",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "2023127063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "desireer@ccbh-ag.com",
            "affiliation": "N",
            "endpointDescription": "work",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7067 N Mariposa St Ste 103",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937202988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.