Healthcare Provider Details

I. General information

NPI: 1528265162
Provider Name (Legal Business Name): ANDREA RUBIN MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12371 LEWIS ST STE 202
GARDEN GROVE CA
92840-4688
US

IV. Provider business mailing address

PO BOX 2493
GARDEN GROVE CA
92842-2493
US

V. Phone/Fax

Practice location:
  • Phone: 714-357-4724
  • Fax: 714-703-9341
Mailing address:
  • Phone: 714-357-4724
  • Fax: 714-703-9341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC38440
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: