Provider Demographics
NPI:1780193722
Name:RUBICZ, CARRIE LYNN
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:RUBICZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1274 AVENIDA FRAGATA
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-7370
Mailing Address - Country:US
Mailing Address - Phone:619-787-0483
Mailing Address - Fax:
Practice Address - Street 1:1237 GREEN OAK RD
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-7821
Practice Address - Country:US
Practice Address - Phone:760-598-2803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor