Provider Demographics
NPI:1720224587
Name:RYAN, STEVE C (MFT)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:C
Last Name:RYAN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2541 STATE ST
Mailing Address - Street 2:102
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1678
Mailing Address - Country:US
Mailing Address - Phone:760-434-3971
Mailing Address - Fax:760-434-5553
Practice Address - Street 1:2541 STATE ST
Practice Address - Street 2:102
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1678
Practice Address - Country:US
Practice Address - Phone:760-434-3971
Practice Address - Fax:760-434-5553
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32779106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist