Active NPI
Ellen G Ruderman, PHD PSYD LCSW
- Psychoanalysis Psychologist
- Encino, CA
National Provider Identifier
1699834960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychoanalysis Psychologist
- License
- CERTIFICATE
- Practice address
- 16055 Ventura Blvd Ste 1110
Encino, CA 91436 - Phone
- (818) 784-7090
- NPI assigned
- Dec 6, 2006
- Last updated
- Sep 11, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychoanalysis Psychologist | 103TP0814X | CERTIFICATE | CA | Primary |
| Clinical Social Worker | 1041C0700X | 000241 | CA |
Addresses
Primary practice location
16055 Ventura Blvd Ste 1110
Encino, CA 91436
Mailing address
16055 Ventura Blvd Ste 1110
Encino, CA 91436
Phone (818) 784-7090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LA #000241 | Other | CA | STATE OF CALIFORNIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000241 | CA | MD | Clinical Social Worker |
| CERTIFICATE | CA | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1699834960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16055 VENTURA BLVD STE 1110",
"city": "ENCINO",
"state": "CA",
"postal_code": "91436",
"telephone_number": "818-784-7090",
"fax_number": "818-981-3477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16055 VENTURA BLVD STE 1110",
"city": "ENCINO",
"state": "CA",
"postal_code": "91436",
"telephone_number": "818-784-7090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDERMAN",
"first_name": "ELLEN",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "PHD PSYD LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TP0814X",
"taxonomy_group": "",
"desc": "Psychologist, Psychoanalysis",
"state": "CA",
"license": "CERTIFICATE",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "000241",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF CALIFORNIA",
"identifier": "LA #000241",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.