Provider Demographics
NPI:1437279189
Name:URRUTIA, RONALD PAUL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:PAUL
Last Name:URRUTIA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 THE ALAMEDA
Mailing Address - Street 2:SUTIE 200
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1131
Mailing Address - Country:US
Mailing Address - Phone:408-857-2754
Mailing Address - Fax:831-454-8374
Practice Address - Street 1:2170 THE ALAMEDA
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1131
Practice Address - Country:US
Practice Address - Phone:408-857-2754
Practice Address - Fax:831-454-8374
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA222801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical