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1912044124
LISA AMY RUDERMAN
LA JOLLA, CA
NPI
1912044124
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: CA MFC37853)
Enumeration Date
2007-01-30
Last Update Date
2007-07-08
Business Address
MRS. LISA AMY RUDERMAN MA MFT
9850 GENESEE AVE 425
LA JOLLA, CA 92037-1224
Phone number: 858-452-8467
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Mailing Address
MRS. LISA AMY RUDERMAN MA MFT
10646 BRIARLAKE WOODS DR
SAN DIEGO, CA 92130-4832
Phone number: 858-481-7477
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