Individual provider Active NPI

Sara Gayle Ruiz

  • Peer Specialist
  • Escondido, CA
National Provider Identifier
1982337556
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
BPYCJD Issued in CA
Practice address
474 W Vermont Ave
Escondido, CA 92025-6584
Phone
(760) 432-9884
NPI assigned
Jul 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Rehabilitation Practitioner 225400000X
Peer Specialist 175T00000X BPYCJD CA Primary

Addresses

Primary practice location

474 W Vermont Ave
Escondido, CA 92025-6584

Mailing address

9465 Farnham St
San Diego, CA 92123-1308
Phone (858) 573-2600

Other practice location 1

9808 Venice Blvd Ste 700
Culver City, CA 90232-6824
Phone (310) 945-3350

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

State licenses

LicenseStateTypeSpecialty
BPYCJDCAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1982337556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9465 FARNHAM ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231308",
            "telephone_number": "858-573-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 W VERMONT AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920256584",
            "telephone_number": "760-432-9884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9808 Venice Blvd Ste 700",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902326824",
            "country_code": "US",
            "telephone_number": "310-945-3350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "SARA",
        "middle_name": "GAYLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "BPYCJD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.