Provider Demographics
NPI:1588157903
Name:RUBIO, JULIETTE ANAIS
Entity type:Individual
Prefix:
First Name:JULIETTE
Middle Name:ANAIS
Last Name:RUBIO
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 1:8200 KERN AVE APT E205
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-4071
Mailing Address - Country:US
Mailing Address - Phone:408-710-1140
Mailing Address - Fax:
Practice Address - Street 1:9360 NO NAME UNO
Practice Address - Street 2:SUITE 130
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020
Practice Address - Country:US
Practice Address - Phone:408-843-9350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst