Healthcare Provider Details

I. General information

NPI: 1053287458
Provider Name (Legal Business Name): MARGARITA RUBIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 ROBERTSON RD
MODESTO CA
95351-3427
US

IV. Provider business mailing address

1821 ROBERTSON RD
MODESTO CA
95351-3427
US

V. Phone/Fax

Practice location:
  • Phone: 209-492-2458
  • Fax: 209-574-8403
Mailing address:
  • Phone: 209-492-2458
  • Fax: 209-574-8403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: