Provider Demographics
NPI:1275953739
Name:RUBIO, ANDREA MARIE (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:RUBIO
Suffix:
Gender:F
Credentials:MA, BCBA
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3001 MISSION OAKS BLVD
Mailing Address - Street 2:UNIT A
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-8710
Mailing Address - Country:US
Mailing Address - Phone:805-383-5566
Mailing Address - Fax:888-659-0031
Practice Address - Street 1:3001 MISSION OAKS BLVD
Practice Address - Street 2:UNIT A
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-8710
Practice Address - Country:US
Practice Address - Phone:805-383-5566
Practice Address - Fax:888-659-0031
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA1-14-15102103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1-14-15102OtherBEHAVIOR ANALYST CERTIFICATION BOARD