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General NPI Number Information
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NPI Number | 1447623657
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Entity Type | Individual
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Provider Name | ADRIAN MICHELLE CAMARGO RUBLY PSY.D
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Gender | Female
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 13051 CENTRAL AVE
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City | CHINO
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State | CA
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Zip | 91710-4124
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Country | US
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Telephone | 951-422-2941
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Fax |
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Provider Business Mailing Address
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Address Line | 7056 ARCHIBALD AVE STE 102-249
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City | EASTVALE
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State | CA
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Zip | 92880-8713
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Country | US
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Telephone | 951-422-2941
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 32146
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License Number State | CA
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