Provider Demographics
NPI:1427198035
Name:MALONEY, RUTH ANN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANN
Last Name:MALONEY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17216 SLOVER AVE
Mailing Address - Street 2:SUITE L
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337-7580
Mailing Address - Country:US
Mailing Address - Phone:909-854-3420
Mailing Address - Fax:909-428-8437
Practice Address - Street 1:17216 SLOVER AVE
Practice Address - Street 2:SUITE L
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337-7580
Practice Address - Country:US
Practice Address - Phone:909-854-3420
Practice Address - Fax:909-428-8437
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT24029101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health