Amber Christine Ruddock, PHD

Individual provider Active NPI Psychologist · Oak Park, CA

NPI 1801925219 · NPPES record last updated May 26, 2011

Key facts

NPI
1801925219
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
PSY22609 (CA)
Practice address
346 Kanan Rd
Ste 203
Oak Park, CA 91377-1100
Phone
(818) 293-7920
Fax
(818) 865-1232
NPI assigned
Mar 2, 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)
Yes
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Family Psychological Services Inc Psychologist Current
since Jun 20, 2013
Accepting new patients

Locations

5014 Chesebro Rd
Fl 2
Agoura Hills, CA 91301
Phone (818) 707-7366

30495 Canwood St
Ste 101
Agoura Hills, CA 91301
Phone (818) 707-7366

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY22609 CA Yes
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

346 Kanan Rd
Ste 203
Oak Park, CA 91377-1100

Mailing address

6648 Buttonwood Ave
Oak Park, CA 91377-1327
Phone (818) 293-7920

Other providers in Oak Park, CA

All providers in Oak Park, CA · Psychologist in California

Sources for this page

Verify at the official NPI Registry.