Provider Demographics
NPI:1376976084
Name:RUBIO, VIRIDIANA
Entity Type:Individual
Prefix:MRS
First Name:VIRIDIANA
Middle Name:
Last Name:RUBIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3186
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79923-3186
Mailing Address - Country:US
Mailing Address - Phone:915-667-4521
Mailing Address - Fax:
Practice Address - Street 1:1401 MONTANA AVE STE B-4
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5673
Practice Address - Country:US
Practice Address - Phone:915-667-4521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional