Provider Demographics
NPI:1891513859
Name:RUT GUBKIN, PHD., A PSYCHOLOGICAL CORPORATION
Entity type:Organization
Organization Name:RUT GUBKIN, PHD., A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHD
Authorized Official - Prefix:DR
Authorized Official - First Name:RUT
Authorized Official - Middle Name:
Authorized Official - Last Name:GUBKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-524-5450
Mailing Address - Street 1:1164 SOLANO AVE # 113
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1639
Mailing Address - Country:US
Mailing Address - Phone:510-524-5450
Mailing Address - Fax:
Practice Address - Street 1:1164 SOLANO AVE # 113
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1639
Practice Address - Country:US
Practice Address - Phone:510-524-5450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty