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Individual

BRIANNA MARIE RUBOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ASW, SUDRC

Contact information

Practice address
1750 5TH AVE, SAN DIEGO, CA 92101
(619) 515-2588
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2300

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16464
CA
1041C0700X
Clinical Social Worker
Primary
117919
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16464
CADTP SUDRC
CA
Enumeration date
10/09/2023
Last updated
10/30/2023
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