Provider Demographics
NPI:1215197850
Name:RUBIO, AILEEN ROMERO (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AILEEN
Middle Name:ROMERO
Last Name:RUBIO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:AILEEN
Other - Middle Name:
Other - Last Name:ROMERO-RUBIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2043 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1253
Mailing Address - Country:US
Mailing Address - Phone:415-661-8787
Mailing Address - Fax:415-661-6708
Practice Address - Street 1:2043 19TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1253
Practice Address - Country:US
Practice Address - Phone:415-661-8787
Practice Address - Fax:415-661-6708
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13969235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist