Provider Demographics
NPI:1306534680
Name:GRUCA, SAUSHA RUTH (MS, LMFT)
Entity type:Individual
Prefix:
First Name:SAUSHA
Middle Name:RUTH
Last Name:GRUCA
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:964 E BADILLO ST # 306
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-2950
Mailing Address - Country:US
Mailing Address - Phone:909-206-4341
Mailing Address - Fax:
Practice Address - Street 1:964 E BADILLO ST # 306
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-2950
Practice Address - Country:US
Practice Address - Phone:909-206-4341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA137331106H00000X
IL166.001731106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist