Provider Demographics
NPI:1083764930
Name:SCHNEIDER, RUTH SUSSKIND (PHD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:SUSSKIND
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16055 VENTURA BLVD STE 1010
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2611
Mailing Address - Country:US
Mailing Address - Phone:818-906-7568
Mailing Address - Fax:310-392-5391
Practice Address - Street 1:16055 VENTURA BLVD STE 1010
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2611
Practice Address - Country:US
Practice Address - Phone:310-906-7568
Practice Address - Fax:310-392-5391
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPS7375103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical