Provider Demographics
NPI:1972905578
Name:DOLEN, RUI CANG (MS)
Entity Type:Individual
Prefix:MRS
First Name:RUI
Middle Name:CANG
Last Name:DOLEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:RUI
Other - Middle Name:
Other - Last Name:CANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1250 E WALNUT ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-1893
Mailing Address - Country:US
Mailing Address - Phone:310-918-5885
Mailing Address - Fax:
Practice Address - Street 1:1250 E WALNUT ST
Practice Address - Street 2:SUITE 110
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1893
Practice Address - Country:US
Practice Address - Phone:310-918-5885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-25
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95555106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist