Provider Demographics
NPI:1306957980
Name:RUBIN, JUDITH ELLEN (LCSW)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ELLEN
Last Name:RUBIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 3RD ST
Mailing Address - Street 2:SUITE #48
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1214
Mailing Address - Country:US
Mailing Address - Phone:415-553-7716
Mailing Address - Fax:
Practice Address - Street 1:401 3RD ST
Practice Address - Street 2:SUITE #48
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1214
Practice Address - Country:US
Practice Address - Phone:415-553-7716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23034101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health