Provider Demographics
NPI:1295187292
Name:RUBIN, DEVON DENISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEVON
Middle Name:DENISE
Last Name:RUBIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 PORTOLA DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1234
Mailing Address - Country:US
Mailing Address - Phone:415-423-4864
Mailing Address - Fax:415-682-4060
Practice Address - Street 1:801 PORTOLA DR
Practice Address - Street 2:SUITE 202
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1234
Practice Address - Country:US
Practice Address - Phone:415-423-4864
Practice Address - Fax:415-682-4060
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS120581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical