Provider Demographics
NPI:1538384508
Name:RUCCIONE PHD, KATHARINE
Entity type:Individual
Prefix:DR
First Name:KATHARINE
Middle Name:
Last Name:RUCCIONE PHD
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KATHARINE
Other - Middle Name:FILASETA
Other - Last Name:RUCCIONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD MFT
Mailing Address - Street 1:2780 SKYPARK DR STE 205
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5343
Mailing Address - Country:US
Mailing Address - Phone:310-530-7750
Mailing Address - Fax:310-530-8371
Practice Address - Street 1:2780 SKYPARK DR STE 205
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5343
Practice Address - Country:US
Practice Address - Phone:310-530-7750
Practice Address - Fax:310-530-8371
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMZ23529106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist