Provider Demographics
NPI:1407053952
Name:RUBIO, RITCHIE JOVERO (PHD)
Entity Type:Individual
Prefix:DR
First Name:RITCHIE
Middle Name:JOVERO
Last Name:RUBIO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 SUNNE LN APT 210
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3610
Mailing Address - Country:US
Mailing Address - Phone:415-608-3039
Mailing Address - Fax:
Practice Address - Street 1:720 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-2535
Practice Address - Country:US
Practice Address - Phone:415-392-4453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2012334103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist