Provider Demographics
NPI:1285702191
Name:RUBIN, JANE L (PSYD; LCSW 3358)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:L
Last Name:RUBIN
Suffix:
Gender:F
Credentials:PSYD; LCSW 3358
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:RUBIN GERSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:48 OZONE AVE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-2410
Mailing Address - Country:US
Mailing Address - Phone:310-208-3313
Mailing Address - Fax:
Practice Address - Street 1:48 OZONE AVE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-2410
Practice Address - Country:US
Practice Address - Phone:310-208-3313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 33581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical