MEDICARE: CHELSEA RUFFOLO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YS0200X	School Counselor	240150097	CA

General Provider Information

NPI Number	:	1245101153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA RUFFOLO

Provider Business Mailing Address
First Line	:	1401 INGLEWOOD AVE
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-3912
Country	:	US
Telephone Number	:	310-379-5449
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 S PROSPECT AVE
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5113
Country	:	US
Telephone Number	:	310-798-8628
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	09/15/2025

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Directions to “ CHELSEA RUFFOLO ” Practice Location

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