Provider Demographics
NPI:1770808032
Name:OLSON, RUTH Y (LMFT)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:Y
Last Name:OLSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:Y
Other - Last Name:VAUGHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8432 MAGNOLIA AVE
Mailing Address - Street 2:BOX 1152
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-3206
Mailing Address - Country:US
Mailing Address - Phone:951-689-1120
Mailing Address - Fax:
Practice Address - Street 1:8432 MAGNOLIA AVE
Practice Address - Street 2:BOX 1152
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-3206
Practice Address - Country:US
Practice Address - Phone:951-689-1120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52740106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist