MEDICARE: CLAIRE S RUBIN MFT

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	106H00000X	Marriage & Family Therapist	37310	CA

General Provider Information

NPI Number	:	1942218011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE S RUBIN MFT

Provider Business Mailing Address
First Line	:	2711 ALCATRAZ AVE STE 4
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2726
Country	:	US
Telephone Number	:	510-339-7068
Fax Number	:	510-262-7310

Provider Business Practice Location Address
First Line	:	2711 ALCATRAZ AVE
Second Line	:	SUITE 5
City	:	BERKELEY
State	:	CA
Zip	:	94705-2726
Country	:	US
Telephone Number	:	510-339-7068
Fax Number	:	510-262-7310

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/08/2007

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