Individual provider · Type 1 NPI

Lisa Amy Ruderman, MA MFT

Mental Health Counselor · La Jolla, CA

NPI number 1912044124 Active

Practice location

9850 Genesee Ave, 425
La Jolla, CA 92037-1224

Call (858) 452-8467 Map

Fax (858) 452-8547

Mailing address

10646 Briarlake Woods Dr
San Diego, CA 92130-4832

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XMFC37853 (CA)

Mental Health Counselor: Definition to come...

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About NPI 1912044124

Lisa Amy Ruderman, MA MFT's National Provider Identifier is 1912044124, issued on Jan 30, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in La Jolla, CA. The record was last updated on Jul 8, 2007.