Provider Demographics
NPI:1275661159
Name:RUFMAN-LEVINE, ALICIA SUSANA (LMFT)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:SUSANA
Last Name:RUFMAN-LEVINE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 S DE LACEY AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2048
Mailing Address - Country:US
Mailing Address - Phone:626-395-7100
Mailing Address - Fax:626-395-7270
Practice Address - Street 1:12501 VAN NUYS BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-1355
Practice Address - Country:US
Practice Address - Phone:818-897-3346
Practice Address - Fax:818-896-6213
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC24232106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist