Provider Demographics
NPI:1689708182
Name:DE RUBIRA, CECILIA M (MFTI)
Entity type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:M
Last Name:DE RUBIRA
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1366 OAKLAND BLVD
Mailing Address - Street 2:APARTMENT # 10
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4343
Mailing Address - Country:US
Mailing Address - Phone:925-899-1696
Mailing Address - Fax:
Practice Address - Street 1:200 24TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-1804
Practice Address - Country:US
Practice Address - Phone:510-412-9243
Practice Address - Fax:510-412-9248
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60148106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist