Provider Demographics
NPI:1003219452
Name:RUELAS-PEREZ, ELIANA (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIANA
Middle Name:
Last Name:RUELAS-PEREZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14550 HAYNES ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1613
Mailing Address - Country:US
Mailing Address - Phone:818-650-6700
Mailing Address - Fax:818-933-3927
Practice Address - Street 1:14550 HAYNES ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1613
Practice Address - Country:US
Practice Address - Phone:818-650-6700
Practice Address - Fax:818-933-3927
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 225400000X, 390200000X
CA854691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program