Provider Demographics
NPI:1639190127
Name:WEININGER, REUBEN (MD)
Entity Type:Individual
Prefix:DR
First Name:REUBEN
Middle Name:
Last Name:WEININGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 DE LA VINA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3129
Mailing Address - Country:US
Mailing Address - Phone:805-569-3313
Mailing Address - Fax:805-690-1043
Practice Address - Street 1:1227 DE LA VINA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3129
Practice Address - Country:US
Practice Address - Phone:805-569-3313
Practice Address - Fax:805-690-1043
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG563532084P0800X, 103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG56353OtherLICENSE
CAE72089Medicare UPIN