Provider Demographics
NPI:1205356136
Name:RUKULE, ANGELA M (LMFT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:RUKULE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21333 OXNARD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-5090
Mailing Address - Country:US
Mailing Address - Phone:818-963-4357
Mailing Address - Fax:818-933-7496
Practice Address - Street 1:21333 OXNARD ST FL 2
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-5090
Practice Address - Country:US
Practice Address - Phone:818-963-4357
Practice Address - Fax:818-933-7496
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMVO23092106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMVO23092OtherPROFESSIONAL LICENSE