Provider Demographics
NPI:1144926775
Name:ESTRADA-RUIZ, MELISSA J
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:J
Last Name:ESTRADA-RUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 BEPPE AVE
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-2078
Mailing Address - Country:US
Mailing Address - Phone:209-207-4509
Mailing Address - Fax:
Practice Address - Street 1:1441 ROSY DAWN LN
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-8452
Practice Address - Country:US
Practice Address - Phone:209-207-4509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist