Provider Demographics
NPI:1831349893
Name:RUBIO, MARY SUZETTE (LMFT)
Entity type:Individual
Prefix:
First Name:MARY SUZETTE
Middle Name:
Last Name:RUBIO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28494 WESTINGHOUSE PL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-0930
Mailing Address - Country:US
Mailing Address - Phone:661-362-4994
Mailing Address - Fax:
Practice Address - Street 1:28494 WESTINGHOUSE PL
Practice Address - Street 2:SUITE 203
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-0930
Practice Address - Country:US
Practice Address - Phone:661-362-4994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 52558106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist