Provider Demographics
NPI:1821316670
Name:ABUAN, RYAN CALUZA (LMFT)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:CALUZA
Last Name:ABUAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 210261
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91921-0261
Mailing Address - Country:US
Mailing Address - Phone:619-289-8653
Mailing Address - Fax:
Practice Address - Street 1:225 W VALLEY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-2613
Practice Address - Country:US
Practice Address - Phone:619-289-8653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85414106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist