Provider Demographics
NPI:1437445939
Name:RUTLEDGE, LEAH (BCBA)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E THOUSAND OAKS BLVD
Mailing Address - Street 2:SUITE 228
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5713
Mailing Address - Country:US
Mailing Address - Phone:877-262-9133
Mailing Address - Fax:877-262-9134
Practice Address - Street 1:301 S MILLER ST
Practice Address - Street 2:SUITE 118
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5205
Practice Address - Country:US
Practice Address - Phone:877-262-9133
Practice Address - Fax:877-262-9134
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-11-8700103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst