Provider Demographics
NPI:1134612278
Name:ANDREA RUBIN MARRIAGE & FAMILY THERAPY INC
Entity type:Organization
Organization Name:ANDREA RUBIN MARRIAGE & FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:714-357-4724
Mailing Address - Street 1:PO BOX 2493
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92842-2493
Mailing Address - Country:US
Mailing Address - Phone:714-357-4724
Mailing Address - Fax:714-703-9341
Practice Address - Street 1:2050 W CHAPMAN AVE STE 225
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2660
Practice Address - Country:US
Practice Address - Phone:714-357-4724
Practice Address - Fax:714-703-9341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-13
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT38440106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty