Provider Demographics
NPI:1972527992
Name:BUSHYEAGER, ANNE RUTH (MS MFT)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:RUTH
Last Name:BUSHYEAGER
Suffix:
Gender:F
Credentials:MS MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16336 WHITTIER BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2900
Mailing Address - Country:US
Mailing Address - Phone:562-902-7848
Mailing Address - Fax:562-902-7879
Practice Address - Street 1:16336 WHITTIER BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2900
Practice Address - Country:US
Practice Address - Phone:562-902-7848
Practice Address - Fax:562-902-7879
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33992106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist