Provider Demographics
NPI:1871717579
Name:RUBIN, BARBRA CAROL (PHD,MFT)
Entity type:Individual
Prefix:DR
First Name:BARBRA
Middle Name:CAROL
Last Name:RUBIN
Suffix:
Gender:F
Credentials:PHD,MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N KINGS RD
Mailing Address - Street 2:#108
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4300
Mailing Address - Country:US
Mailing Address - Phone:323-650-9649
Mailing Address - Fax:
Practice Address - Street 1:1010 N KINGS RD
Practice Address - Street 2:#108
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-4300
Practice Address - Country:US
Practice Address - Phone:323-650-9649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT20332106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist