Provider Demographics
NPI:1992366314
Name:MORIN, RUTH TZIPORA (PHD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:TZIPORA
Last Name:MORIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:TZIPORA
Other - Last Name:BORNSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16405 SAND CANYON AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3787
Mailing Address - Country:US
Mailing Address - Phone:949-336-8633
Mailing Address - Fax:
Practice Address - Street 1:16405 SAND CANYON AVE STE 220
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3787
Practice Address - Country:US
Practice Address - Phone:949-336-8633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301017855103TC0700X
CA32825103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical