ILLUME PSYCHOLOGY INCORPORATED
NPI 1952070252
Psychologist - Clinical Child & Adolescent in Petaluma, CA

Q: What is Illume Psychology Incorporated's NPI number?

The NPI number for Illume Psychology Incorporated is 1952070252. It was assigned to this organization in the NPPES registry on September 9, 2021.

Q: What is Illume Psychology Incorporated's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Active since September 09, 2021

245 KENTUCKY STREET, SUITE A, PETALUMA, CA 94952(707) 216-1612 Get Directions Write a Review

NPPES record last updated: September 9, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Illume Psychology Incorporated NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ILLUME PSYCHOLOGY INCORPORATED (NPI 1952070252) is a healthcare organization registered as a clinical child & adolescent in Petaluma, California and active in the NPI registry since September 2021. The organization lists Larissa Laska-ruebusch, President, as its authorized official.

NPPES Registry Identity

NPI1952070252

Entity TypeOrganization

Primary Taxonomy103TC2200X

Legal Business NameILLUME PSYCHOLOGY INCORPORATED

Location Address245 KENTUCKY STREET, SUITE APetaluma, CA 94952

Mailing Address245 Kentucky Street, Suite APetaluma, CA 94952 · (707) 216-1612

Phone(707) 216-1612

Organization SubpartNo

Authorized OfficialLarissa Laska-ruebuschPresident · (707) 216-1612

Enumeration DateSeptember 9, 2021

NPPES CertifiedSeptember 9, 2021

✔ NPI 1952070252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

245 KENTUCKY STREET, Petaluma, CA 94952

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Illume Psychology Incorporated's NPI number?

The NPI number for Illume Psychology Incorporated is 1952070252. It was assigned to this organization in the NPPES registry on September 9, 2021.

Where is Illume Psychology Incorporated located?

Illume Psychology Incorporated is located at 245 Kentucky Street Suite A, Petaluma, CA 94952. The listed phone number is (707) 216-1612.

What is Illume Psychology Incorporated's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

When was this NPI record last updated?

The NPPES record for Illume Psychology Incorporated was last updated on September 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.