Provider Demographics
NPI:1710909619
Name:RUBEN, NANCY (MFT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:RUBEN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 S BENTLEY AVE
Mailing Address - Street 2:#400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5667
Mailing Address - Country:US
Mailing Address - Phone:310-444-9437
Mailing Address - Fax:
Practice Address - Street 1:1917 1/2 WESTWOOD BLVD
Practice Address - Street 2:#2
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-8412
Practice Address - Country:US
Practice Address - Phone:310-444-9437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34886106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist