Matthew A Ruderman, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY27452 Issued in CA

Practice address

1339 20TH St
Santa Monica, CA 90404-2033

Phone

(310) 829-8921

NPI assigned

Sep 12, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1750716494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 20TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 20TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042033",
            "telephone_number": "310-829-8921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDERMAN",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-12",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY27452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Rubin
• Todd Gabriel Rubin, MD, PHD
• Allison Rubinowitz
• Adam Rubio
• Erica Nicole Ruccia, APRN-CNP
• Alicia Renae Ruelaz Maher, M.D.
• Katherine Del Carmen Ruiz Soto, MD
• Caio Augusto Ruiz
• Janet Ruiz, DPT
• Tamara Michele Rumburg, PSY.D.

• Clinical Child & Adolescent Psychologist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.