Provider Demographics
NPI:1528317286
Name:THE CRUZ CENTER, P.C.
Entity type:Organization
Organization Name:THE CRUZ CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:818-294-0318
Mailing Address - Street 1:10727 WHITE OAK AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-4631
Mailing Address - Country:US
Mailing Address - Phone:818-294-0318
Mailing Address - Fax:
Practice Address - Street 1:10727 WHITE OAK AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-4631
Practice Address - Country:US
Practice Address - Phone:818-294-0318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-09
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT6650225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty