Provider Demographics
NPI:1275265886
Name:RUBINO, LIA JACQUELINE (MS)
Entity type:Individual
Prefix:
First Name:LIA
Middle Name:JACQUELINE
Last Name:RUBINO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:LI
Other - Middle Name:JAC
Other - Last Name:RUBINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:1245 UMPQUA AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-6008
Mailing Address - Country:US
Mailing Address - Phone:541-204-0385
Mailing Address - Fax:
Practice Address - Street 1:1245 UMPQUA AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-6008
Practice Address - Country:US
Practice Address - Phone:541-204-0385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR11084101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health