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General NPI Number Information
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NPI Number | 1548316722
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Entity Type | Individual
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Provider Name | ELLEN VARVITSIOTES RUIZ M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 01/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1026 OAK GROVE RD SUITE 11
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City | CONCORD
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State | CA
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Zip | 94518-3289
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Country | US
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Telephone | 925-646-5459
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Fax | 915-646-5102
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Provider Business Mailing Address
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Address Line | 1134 DELAWARE ST SUITE D
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City | BERKELEY
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State | CA
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Zip | 94702-1672
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Country | US
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Telephone | 510-524-2398
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Fax | 510-288-1337
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 42350
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License Number State | CA
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