Provider Demographics
NPI:1780026625
Name:ARVISO-RICHMOND, RUTH D (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:D
Last Name:ARVISO-RICHMOND
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W THOUSAND OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4402
Mailing Address - Country:US
Mailing Address - Phone:619-384-5024
Mailing Address - Fax:
Practice Address - Street 1:125 W THOUSAND OAKS BLVD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4402
Practice Address - Country:US
Practice Address - Phone:805-777-5336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATRAINEE103TC0700X, 390200000X
CA31917103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program