MEDICARE: MS. MICHELE ANITA RUBENSTEIN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS15597	CA

General Provider Information

NPI Number	:	1174636583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELE ANITA RUBENSTEIN LCSW

Provider Business Mailing Address
First Line	:	3000 DAMANI CT UNIT 102
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94506-6033
Country	:	US
Telephone Number	:	925-413-2977
Fax Number	:

Provider Business Practice Location Address
First Line	:	2821 CROW CANYON RD
Second Line	:	SUITE 202
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1659
Country	:	US
Telephone Number	:	925-413-2977
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	04/21/2020

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