Basic Information
| Provider Information | |||||||||
| NPI: | 1326406323 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUIZ ARZAPALO | ||||||||
| FirstName: | EDGAR | ||||||||
| MiddleName: | ABELARDO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3117 WILSON RD | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933045319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613244756 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3117 WILSON RD | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933045319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613244756 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/04/2016 | ||||||||
| LastUpdateDate: | 05/05/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 7604 | CA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator | 101YA0400X | R1292600218 | CA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.