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General NPI Number Information
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NPI Number | 1982754420
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Entity Type | Individual
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Provider Name | PEGGY S. RUUD LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 11/05/2010
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Provider Practice Location Address
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Address Line | 2307 N. FINE STREET, SUITE 114 HOURGLASS BUILDING
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City | FRESNO
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State | CA
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Zip | 93727
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Country | US
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Telephone | 559-312-6553
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Fax | 559-453-2420
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Provider Business Mailing Address
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Address Line | 1443 N VAGEDES AVE
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City | FRESNO
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State | CA
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Zip | 93728-1411
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Country | US
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Telephone | 559-312-6553
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Fax | 559-453-2420
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS14949
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License Number State | CA
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