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General NPI Number Information
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NPI Number | 1063176261
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Entity Type | Individual
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Provider Name | MRS. ELSA ABIGAIL RUBENSTEIN
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Gender | Female
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Dates
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Enumeration Date | 10/25/2021
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 201 ALAMEDA DEL PRADO STE 201
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City | NOVATO
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State | CA
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Zip | 94949-6698
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Country | US
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Telephone | 415-798-6248
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Fax |
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Provider Business Mailing Address
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Address Line | 525 COLLEGE AVE STE 221
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City | SANTA ROSA
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State | CA
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Zip | 95404-4118
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Country | US
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Telephone | 707-494-2059
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Fax | 707-595-5951
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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