MEDICARE: ERICA RENEE RUBIO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	17515	CA
2	106H00000X	Marriage & Family Therapist	148997	CA

General Provider Information

NPI Number	:	1740166859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA RENEE RUBIO

Provider Business Mailing Address
First Line	:	16909 PARTHENIA ST STE 105
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91343-4561
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	31111 AGOURA RD STE 220
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-4445
Country	:	US
Telephone Number	:	213-375-4522
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2025
Last Update Date	:	08/13/2025

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Directions to “ ERICA RENEE RUBIO ” Practice Location

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