Provider Demographics
NPI:1639549736
Name:RUBIN, DAVID NATHAN (MS, PPS, LMFT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:NATHAN
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MS, PPS, LMFT
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 111704
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95011-1704
Mailing Address - Country:US
Mailing Address - Phone:818-495-4073
Mailing Address - Fax:
Practice Address - Street 1:109 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2629
Practice Address - Country:US
Practice Address - Phone:818-456-9866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120575046101YS0200X
CALMFT88029106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool