Healthcare Provider Details

I. General information

NPI: 1437657558
Provider Name (Legal Business Name): RUTH ELLEN EMERSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 01/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 SAN JOSE ST
SALINAS CA
93901-3901
US

IV. Provider business mailing address

1172 S MAIN ST # 125
SALINAS CA
93901-2204
US

V. Phone/Fax

Practice location:
  • Phone: 800-214-5439
  • Fax: 831-796-0334
Mailing address:
  • Phone: 800-214-5439
  • Fax: 831-796-0334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number64293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: