Provider Demographics
NPI:1750432290
Name:RUDOY, ELINA (MFTI)
Entity type:Individual
Prefix:
First Name:ELINA
Middle Name:
Last Name:RUDOY
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 EXECUTIVE PARK BLVD
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-3303
Mailing Address - Country:US
Mailing Address - Phone:415-871-8805
Mailing Address - Fax:
Practice Address - Street 1:150 EXECUTIVE PARK BLVD
Practice Address - Street 2:SUITE 4000
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94134-3303
Practice Address - Country:US
Practice Address - Phone:415-871-8805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health