Clifford Allen Ruyle Jr., LCSW, CGP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 26809 Issued in CA

Practice address

3465 Camino del Rio S Ste 320
San Diego, CA 92108-3909

Phone

(619) 213-3000

Fax

(866) 302-7589

NPI assigned

Jul 4, 2011

Last updated

Mar 17, 2018By the provider in NPPES

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 1

Other names 1

• C. Allen Ruyle Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• C Allen Ruyle Licensed Clinical Social Worker, Inc.

  dba Well Being Psychotherapy

  • Clinical Social Worker
  • San Diego, CA
  • NPI 1710366802
  NPD (past)
• C. Allen Ruyle, LCSW

  • Clinical Social Worker
  • San Diego, CA
  • NPI 1083991996
  NPD (past)

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

{
    "created_epoch": "1309737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1912294547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 CAMINO DEL RIO S STE 320",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083909",
            "telephone_number": "619-213-3000",
            "fax_number": "866-302-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3465 CAMINO DEL RIO S STE 320",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083909",
            "telephone_number": "619-213-3000",
            "fax_number": "866-302-7589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Olive St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921036215",
            "country_code": "US",
            "telephone_number": "619-213-3000",
            "fax_number": "866-302-7589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUYLE",
        "first_name": "CLIFFORD",
        "middle_name": "ALLEN",
        "name_suffix": "Jr.",
        "credential": "LCSW, CGP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 26809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912294547",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C.",
            "last_name": "RUYLE",
            "middle_name": "ALLEN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Charissa A Ruud, L.C.S.W.
• Irma Lisette Ruvalcaba
• Kenia Ruvalcaba
• Kimberly Ruvalcaba
• Sharline Nicol Ruvalcaba, RADT-1
• Jessica Ruzich, PHARMD
• RWW Home & Community Rehab Services, Inc.
• Ryan M. Wilke, D.O., a Medical Corporation
• Kaila Ryan Nduaguba, PT
• Ryan Silbernick

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.