Provider Demographics
NPI:1316286099
Name:RUANE, ANNE C (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:C
Last Name:RUANE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:C
Other - Last Name:GOLDHORN RUANE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:2898 ROWENA AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039
Mailing Address - Country:US
Mailing Address - Phone:323-212-4799
Mailing Address - Fax:323-212-4799
Practice Address - Street 1:2898 ROWENA AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-2020
Practice Address - Country:US
Practice Address - Phone:323-212-4799
Practice Address - Fax:323-212-4799
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25507103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical