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DR. ELLEN G RUDERMAN PHD PSYD LCSW

Psychoanalysis

Encino, California

Provider NPI: 1699834960

Provider Information:
DR. ELLEN G RUDERMAN PHD PSYD LCSW
Gender: F
Not Sole Proprietor

Practice Location:
16055 VENTURA BLVD STE 1110  ENCINO, CA 91436 US
Tel: 818-784-7090  Fax: --

Business Mailing Address:
16055 VENTURA BLVD STE 1110  ENCINO, CA 91436 US
Tel: 818-784-7090  Fax: 818-981-3477

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103TP0814XBehavioral Health & Social Service Providers
Psychologist
Psychoanalysis
CACERTIFICATE
X1041C0700XBehavioral Health & Social Service Providers
Social Worker
CA000241

Other Provider Identifiers:

IssuerNumberStateType
STATE OF CALIFORNIALA #000241CA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







PSYCHOANALYSIS JOBS CA - Page 1

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