Provider Demographics
NPI:1962640300
Name:GREENBERG, RUTH (MFT)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 NORVELL ST
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3246
Mailing Address - Country:US
Mailing Address - Phone:510-717-4485
Mailing Address - Fax:
Practice Address - Street 1:754 NORVELL ST
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-3246
Practice Address - Country:US
Practice Address - Phone:510-717-4485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45630106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist