Provider Demographics
NPI:1225373863
Name:RUBENS, KARA C
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:C
Last Name:RUBENS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KARA
Other - Middle Name:C
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2940 SUMMIT ST STE 2E
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3416
Mailing Address - Country:US
Mailing Address - Phone:510-633-3221
Mailing Address - Fax:
Practice Address - Street 1:1918 BONITA AVE STE 200
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1014
Practice Address - Country:US
Practice Address - Phone:415-669-4779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5899101YM0800X, 101YM0800X
225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA12471OtherLICENSED PROFESSIONAL CLINICAL COUNSELOR