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General NPI Number Information
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NPI Number | 1396417218
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Entity Type | Organization
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Legal Business Name | EVA K. RUBIN, LICENSED CLINICAL SOCIAL WORKER, INC.
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Dates
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Enumeration Date | 09/29/2021
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 230 N MAR VISTA AVE
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City | PASADENA
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State | CA
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Zip | 91106-1411
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Country | US
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Telephone | 510-858-7877
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Fax | 888-425-0567
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Provider Business Mailing Address
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Address Line | 230 N MAR VISTA AVE
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City | PASADENA
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State | CA
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Zip | 91106-1411
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Country | US
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Telephone | 510-858-7877
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Fax | 888-425-0567
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. EVA K. RUBIN
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Credential | MPH, LCSW
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Telephone | 510-858-7877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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