| Ruark Psychotherapy Apc | |
|
3020 Castle Heights Ave Los Angeles CA 90034-2753 | |
| (310) 837-7979 | |
| Not Available |
| Full Name | Ruark Psychotherapy Apc |
|---|---|
| Speciality | Psychologist |
| Location | 3020 Castle Heights Ave, Los Angeles, California |
| Authorized Official Name and Position | Daniel Ruark (PRESIDENT) |
| Authorized Official Contact | 3108377979 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ruark Psychotherapy Apc 9854 National Blvd Suite 372 Los Angeles CA 90034-2713 Ph: (310) 837-7979 | Ruark Psychotherapy Apc 3020 Castle Heights Ave Los Angeles CA 90034-2753 Ph: (310) 837-7979 |
| NPI Number | 1780081547 |
|---|---|
| Provider Enumeration Date | 11/21/2014 |
| Last Update Date | 11/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780081547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY10329 (California) | Primary |
| 106H00000X | Marriage & Family Therapist | MFT34153 (California) | Secondary |
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