Provider Demographics
NPI:1043509128
Name:SCOTT-RUELAS, SARAH (PSYD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SCOTT-RUELAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12626 RIVERSIDE DR STE 409
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3451
Mailing Address - Country:US
Mailing Address - Phone:818-661-6306
Mailing Address - Fax:
Practice Address - Street 1:12626 RIVERSIDE DR STE 409
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3451
Practice Address - Country:US
Practice Address - Phone:818-661-6306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAPSY32307103T00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist