Provider Demographics
NPI:1063643666
Name:RUBY-WAHBA, JILL L (MA, MFT, ATR)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:L
Last Name:RUBY-WAHBA
Suffix:
Gender:F
Credentials:MA, MFT, ATR
Other - Prefix:
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Mailing Address - Street 1:1061 AVENUE H
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5101
Mailing Address - Country:US
Mailing Address - Phone:130-720-1784
Mailing Address - Fax:310-540-6590
Practice Address - Street 1:2790 SKYPARK DR
Practice Address - Street 2:SUITE 210
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5300
Practice Address - Country:US
Practice Address - Phone:424-254-9393
Practice Address - Fax:424-634-7688
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health