MEDICARE: RUTH HAN

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	101YM0800X	Mental Health Counselor	36991	CA

General Provider Information

NPI Number	:	1922418011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH HAN

Provider Business Mailing Address
First Line	:	1328 2ND ST
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-1122
Country	:	US
Telephone Number	:	310-394-6889
Fax Number	:	310-394-6883

Provider Business Practice Location Address
First Line	:	7160 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90046-4416
Country	:	US
Telephone Number	:	323-798-4474
Fax Number	:

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

Provider Enumeration Date	:	04/29/2014
Last Update Date	:	04/29/2014

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Directions to “ RUTH HAN ” Practice Location

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