Individual provider Active NPI

Lydia Ruark, PH.D.

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1992103899
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY10329 Issued in CA
Practice address
3020 Castle Heights Ave
Los Angeles, CA 90034-2753
Phone
(310) 837-7979
NPI assigned
Dec 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY10329 CA Primary

Addresses

Primary practice location

3020 Castle Heights Ave
Los Angeles, CA 90034-2753

Mailing address

9854 National Blvd Ste 372
Los Angeles, CA 90034-2713

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

LicenseStateTypeSpecialty
PSY10329CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ruark Psychotherapy Apc Psychologist Past Accepting new patients

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": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1992103899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9854 NATIONAL BLVD STE 372",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900342713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CASTLE HEIGHTS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900342753",
            "telephone_number": "310-837-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUARK",
        "first_name": "LYDIA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY10329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; 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.