Provider Demographics
NPI:1811596109
Name:JIMENEZ-RUBLE, LUISA (PSYD)
Entity type:Individual
Prefix:
First Name:LUISA
Middle Name:
Last Name:JIMENEZ-RUBLE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 LAND HBR
Mailing Address - Street 2:
Mailing Address - City:NEWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28657-7923
Mailing Address - Country:US
Mailing Address - Phone:919-815-1370
Mailing Address - Fax:
Practice Address - Street 1:CORNER OF LAMONT AND VETERANS WAY
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:28657
Practice Address - Country:US
Practice Address - Phone:234-926-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist