Provider Demographics
NPI:1770837825
Name:OLIANSKY, INGRID RUTH (LMFT)
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:RUTH
Last Name:OLIANSKY
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 1:18034 VENTURA BLVD # 174
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3516
Mailing Address - Country:US
Mailing Address - Phone:818-927-3855
Mailing Address - Fax:818-935-6020
Practice Address - Street 1:18034 VENTURA BLVD # 174
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3516
Practice Address - Country:US
Practice Address - Phone:818-927-3855
Practice Address - Fax:818-935-6020
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-27
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC48975106H00000X
CAMFC 48975106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8767941Medicaid