Provider Demographics
NPI:1578750295
Name:RUBIO, AMY RYANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:RYANNE
Last Name:RUBIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 EL MAR CT
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-6694
Mailing Address - Country:US
Mailing Address - Phone:831-345-2035
Mailing Address - Fax:
Practice Address - Street 1:3065 PORTER ST STE 105
Practice Address - Street 2:
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2231
Practice Address - Country:US
Practice Address - Phone:831-476-1430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor