Ruth Ariella Dergicz, PHD

Individual provider Active NPI Mental Health Counselor · Piedmont, CA

NPI 1538367347 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1538367347
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
1250 Grand Ave
Piedmont, CA 94610-1002
Phone
(510) 655-7880
Fax
(510) 655-3379
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Ann Martin Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

1250 Grand Ave
Piedmont, CA 94610-1002

Mailing address

1250 Grand Ave
Piedmont, CA 94610-1002
Phone (510) 655-7880

Other providers in Piedmont, CA

All providers in Piedmont, CA · Mental Health Counselor in California

Sources for this page

Verify at the official NPI Registry.