Provider Demographics
NPI:1174057780
Name:RUBIN, ANNE (MS, RDN)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3834 CORINA WAY
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4505
Mailing Address - Country:US
Mailing Address - Phone:650-665-9580
Mailing Address - Fax:
Practice Address - Street 1:3834 CORINA WAY
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4505
Practice Address - Country:US
Practice Address - Phone:650-665-9580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86023405133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered