Healthcare Provider Details

I. General information

NPI: 1801832753
Provider Name (Legal Business Name): MARIA A RUBINO GAAB PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA RUBINO

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 N 6TH ST SUITE 115A
FRESNO CA
93710-7514
US

IV. Provider business mailing address

PO BOX 1987
OAKHURST CA
93644-1987
US

V. Phone/Fax

Practice location:
  • Phone: 559-676-5204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 20436
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPSY 20436
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License NumberPSY 20436
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY 20436
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: