Individual
LYDIA RUARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3020 CASTLE HEIGHTS AVE, LOS ANGELES, CA 90034-2753
(310) 837-7979
Mailing address
9854 NATIONAL BLVD STE 372, LOS ANGELES, CA 90034-2713
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY10329
CA
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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