Healthcare Provider Details

I. General information

NPI: 1013822006
Provider Name (Legal Business Name): MATA PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 RAMAPO VALLEY RD STE 203B
OAKLAND NJ
07436-2716
US

IV. Provider business mailing address

410 RAMAPO VALLEY RD STE 203B
OAKLAND NJ
07436-2716
US

V. Phone/Fax

Practice location:
  • Phone: 201-907-7915
  • Fax: 201-502-4881
Mailing address:
  • Phone: 201-907-7915
  • Fax: 201-502-4881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: VALERIE LYNN RUBERTO
Title or Position: MANAGING MEMBER
Credential: PMHNP-BC
Phone: 551-427-0373