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General NPI Number Information
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NPI Number | 1487353850
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Entity Type | Individual
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Provider Name | SHELLEY RUELAS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 05/13/2023
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Provider Practice Location Address
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Address Line | 1601 CARMEN DR STE 211
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City | CAMARILLO
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State | CA
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Zip | 93010-3103
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Country | US
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Telephone | 805-517-0532
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Fax |
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Provider Business Mailing Address
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Address Line | 2060D E AVENIDA DE LOS ARBOLES STE 533
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-1376
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY24278
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License Number State | CA
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