Provider Demographics
NPI:1023881695
Name:RUCOBO, KARMINA
Entity type:Individual
Prefix:
First Name:KARMINA
Middle Name:
Last Name:RUCOBO
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 1:44700 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-3016
Mailing Address - Country:US
Mailing Address - Phone:760-848-5030
Mailing Address - Fax:
Practice Address - Street 1:44700 SHERWOOD DR
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-3016
Practice Address - Country:US
Practice Address - Phone:760-848-5030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist