Active NPI
Janet R Rubacher, AMFT110484
- Marriage & Family Therapist
- Gardena, CA
National Provider Identifier
1578697587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 149466
- Practice address
- 108 W Victoria St
Gardena, CA 90248-3523 - Phone
- (310) 607-0290
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 110484 | CA | |
| Marriage & Family Therapist | 106H00000X | 149466 | CA | Primary |
| Marriage & Family Therapist | 106H00000X | 74121 | CA |
Addresses
Primary practice location
108 W Victoria St
Gardena, CA 90248-3523
Mailing address
311 Loma Vista St
El Segundo, CA 90245-2902
Phone (310) 529-1239
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578697587 | Other | CA | AMFT 110484 |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | N/A | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149466 | CA | MD | Marriage & Family Therapist |
| 110484 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733097600000",
"number": "1578697587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 LOMA VISTA ST",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902452902",
"telephone_number": "310-529-1239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 W VICTORIA ST",
"city": "GARDENA",
"state": "CA",
"postal_code": "902483523",
"telephone_number": "310-607-0290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBACHER",
"first_name": "JANET",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "AMFT110484",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2024-12-02",
"certification_date": "2024-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "110484",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "149466",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "74121",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMFT 110484",
"identifier": "1578697587",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "N/A",
"affiliation": "N",
"endpointDescription": "N/A",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "311 Loma Vista St",
"city": "El Segundo",
"state": "CA",
"country_code": "US",
"postal_code": "902452902",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.