Provider Demographics
NPI:1235924705
Name:CEBOLLERO RUIZ, NATALIA CRISTINA
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:CRISTINA
Last Name:CEBOLLERO RUIZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2167 COWLEY WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-1127
Mailing Address - Country:US
Mailing Address - Phone:619-518-7710
Mailing Address - Fax:
Practice Address - Street 1:1081 CAMINO DEL RIO S
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3542
Practice Address - Country:US
Practice Address - Phone:858-398-7641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF3437076106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician