Individual provider Active NPI

Rudy Ruderman, LMFT

  • Marriage & Family Therapist
  • Santa Barbara, CA
National Provider Identifier
1750830592
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
125808 Issued in CA
Practice address
615 State St
Santa Barbara, CA 93101-3301
Phone
(805) 312-8078
NPI assigned
Sep 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Marriage & Family Therapist 106H00000X 125808 CA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

615 State St
Santa Barbara, CA 93101-3301

Mailing address

615 State St
Santa Barbara, CA 93101-3301
Phone (312) 888-1083

Other practice location 1

1023 Burlington Ave
Western Springs, IL 60558-1516
Phone (708) 745-5277

Other practice location 2

1722 S Lewis Rd
Camarillo, CA 93012-8520
Phone (805) 366-4040

Other practice location 3

5266 Hollister Ave Ste 321
Goleta, CA 93111-2083
Phone (805) 312-8078

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

State licenses

LicenseStateTypeSpecialty
125808CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Psychotherapy & Integrative Health, a Marriage & Family the Marriage & Family Therapist CurrentSince Aug 28, 2022 Accepting new patients

Locations

922 State St
Ste A
Santa Barbara, CA 93101
Phone (805) 312-8078

615 State St
Santa Barbara, CA 93101
Phone (805) 312-8078

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.

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1750830592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 STATE ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931013301",
            "telephone_number": "312-888-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 STATE ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931013301",
            "telephone_number": "805-312-8078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1023 Burlington Ave",
            "address_purpose": "LOCATION",
            "city": "Western Springs",
            "state": "IL",
            "postal_code": "605581516",
            "country_code": "US",
            "telephone_number": "708-745-5277",
            "fax_number": "708-784-9451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1722 S Lewis Rd",
            "address_purpose": "LOCATION",
            "city": "Camarillo",
            "state": "CA",
            "postal_code": "930128520",
            "country_code": "US",
            "telephone_number": "805-366-4040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5266 Hollister Ave Ste 321",
            "address_purpose": "LOCATION",
            "city": "Goleta",
            "state": "CA",
            "postal_code": "931112083",
            "country_code": "US",
            "telephone_number": "805-312-8078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDERMAN",
        "first_name": "RUDY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-21",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125808",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.