Individual provider Active NPI

Iris Marisol Ruelas

  • Addiction (Substance Use Disorder) Counselor
  • Stockton, CA
National Provider Identifier
1811558794
Registry record updated Jun 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1947 N California St Ste B&C
Stockton, CA 95204-6029
Phone
(209) 463-0870
NPI assigned
Jun 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

1947 N California St Ste B&C
Stockton, CA 95204-6029

Mailing address

222 E Worth St
Stockton, CA 95206-1326
Phone (209) 272-9699

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Treatment Centers, LLC Past Accepting new patients
Aegis Treatment Centers, LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1561161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561161600000",
    "number": "1811558794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E WORTH ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952061326",
            "telephone_number": "209-272-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1947 N CALIFORNIA ST STE B&C",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046029",
            "telephone_number": "209-463-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUELAS",
        "first_name": "IRIS",
        "middle_name": "MARISOL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-22",
        "last_updated": "2019-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2019; 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.