Provider Demographics
NPI:1548913353
Name:RUIZ PSYCHOLOGY GROUP, LLC
Entity type:Organization
Organization Name:RUIZ PSYCHOLOGY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARLEENE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ PACHECO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-519-8587
Mailing Address - Street 1:HC 3 BOX 24007
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-9734
Mailing Address - Country:US
Mailing Address - Phone:787-519-8587
Mailing Address - Fax:
Practice Address - Street 1:PR -2 K.M. 1.59 AVENIDA HOSTOS, VILLA CAPITAN II
Practice Address - Street 2:SUITE 202
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:939-499-5888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty