Philip Ruddy

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT107495 Issued in CA

Practice address

205 Pasadena Ave
South Pasadena, CA 91030

Phone

(323) 344-5536

NPI assigned

Jan 9, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Soultenders, Inc.

  • Clinical Psychologist
  • Arcadia, CA
  • NPI 1164617007
  Medicare reassignment NPD
• Soultenders Psychological Services, Inc.

  • Clinical Social Worker
  • Arcadia, CA
  • NPI 1235810722
  NPD
• Institute for the Redesign of Learning

  • Marriage & Family Therapist
  • South Pasadena, CA
  • NPI 1124212295
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1699211185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PASADENA AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302919",
            "telephone_number": "323-344-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PASADENA AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "91030",
            "telephone_number": "323-344-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDY",
        "first_name": "PHILIP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-09",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT107495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7667",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7184",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7368",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7708",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mona Ross, LCSW
• Rikki C Rothenberg, LMFT
• Maria Virginia Ruano, PT
• Jose Rubalcaba
• Jason David Rubin, M.S.W., LCSW
• Isaac Ruiz
• Jonathan Ruiz
• Jannah Nadine Rulfs, OTR/L
• Kendall Louise Saddler
• Elia Saint Karene, LMFT

• Marriage & Family Therapist in South Pasadena, CA
• Providers in South Pasadena, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.