Provider Demographics
NPI:1346020930
Name:RUIBAL, ARTINA RAY (BD, DNM, MDIV, CAS)
Entity type:Individual
Prefix:
First Name:ARTINA
Middle Name:RAY
Last Name:RUIBAL
Suffix:
Gender:F
Credentials:BD, DNM, MDIV, CAS
Other - Prefix:
Other - First Name:RAMONA
Other - Middle Name:CHRISTINE
Other - Last Name:SORIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BD, DNM, MDIV, CAS
Mailing Address - Street 1:11920 W ALAMEDA PKWY
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2707
Mailing Address - Country:US
Mailing Address - Phone:720-325-3593
Mailing Address - Fax:
Practice Address - Street 1:11920 W ALAMEDA PKWY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2707
Practice Address - Country:US
Practice Address - Phone:720-325-3593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YP1600X, 133NN1002X, 171400000X, 174H00000X, 374K00000X
COACC.0021334101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner