Provider Demographics
NPI:1871044750
Name:RUBIO GUTIERREZ, MARIA DEL MAR (LMFT)
Entity Type:Individual
Prefix:
First Name:MARIA DEL MAR
Middle Name:
Last Name:RUBIO GUTIERREZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 BLACKWELL DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-1427
Mailing Address - Country:US
Mailing Address - Phone:619-942-6504
Mailing Address - Fax:
Practice Address - Street 1:3007 BLACKWELL DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-1427
Practice Address - Country:US
Practice Address - Phone:619-942-6504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LMFT135157106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist