Provider Demographics
NPI:1427690437
Name:RUBIO, MICHELLE CADIZ (MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:CADIZ
Last Name:RUBIO
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:CABATO
Other - Last Name:CADIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, FNP-C
Mailing Address - Street 1:982 E BOORNAZIAN AVE
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:CA
Mailing Address - Zip Code:93625-9813
Mailing Address - Country:US
Mailing Address - Phone:559-813-0506
Mailing Address - Fax:
Practice Address - Street 1:155 S NEWMARK AVE
Practice Address - Street 2:
Practice Address - City:PARLIER
Practice Address - State:CA
Practice Address - Zip Code:93648-2531
Practice Address - Country:US
Practice Address - Phone:559-646-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95013039Medicaid