Provider Information for 1295286326
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JAY JIAYUAN RUAN LCSW
Other Names:Former Name:JIAYUAN RUANSex: Male
NPI: 1295286326
Last Updated: 2024-02-26
Certification Date: 2024-02-26
Certification Date: 2024-02-26
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1295286326 | ||||||||||||||||||||
| Enumeration Date | 2016-10-24 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 2820 E GARVEY AVE S PMB 20 WEST COVINA, CA 91791-2115 United States Phone: 626-539-7008 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 9353 VALLEY BLVD ROSEMEAD, CA 91770-1934 United States Phone: 626-287-2988 | Fax:626-287-1937 | ||||||||||||||||||||
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