Provider Demographics
NPI:1013705904
Name:BLEDSOE, RUTH JOY
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:JOY
Last Name:BLEDSOE
Suffix:
Gender:
Credentials:
Other - Prefix:MS
Other - First Name:RUTH
Other - Middle Name:JOY
Other - Last Name:PINKNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:145 W 22ND ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-1405
Mailing Address - Country:US
Mailing Address - Phone:213-741-3744
Mailing Address - Fax:
Practice Address - Street 1:145 W 22ND ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-1405
Practice Address - Country:US
Practice Address - Phone:213-741-3744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)