Provider Demographics
NPI:1093215014
Name:RUFFIN, CATHY ALICIA (LICSW)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:ALICIA
Last Name:RUFFIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:ALICIA
Other - Last Name:RUFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1 EMBARCADERO CTR STE 1900
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3723
Mailing Address - Country:US
Mailing Address - Phone:888-663-6331
Mailing Address - Fax:
Practice Address - Street 1:1 EMBARCADERO CTR STE 1900
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-3723
Practice Address - Country:US
Practice Address - Phone:888-663-6331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-16
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500788391041C0700X
CA928471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical