MEDICARE: DR. DORI OBADIA DUBIN PSYD LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	102L00000X	Psychoanalyst	LCS9393	CA
2	1041C0700X	Clinical Social Worker	LCS9393	CA

General Provider Information

NPI Number	:	1124241690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DORI OBADIA DUBIN PSYD LCSW

Provider Business Mailing Address
First Line	:	5845 COLLEGE AVENUE
Second Line	:	SUITE 4
City	:	OAKLAND
State	:	CA
Zip	:	94618-1635
Country	:	US
Telephone Number	:	510-547-2522
Fax Number	:	510-595-3308

Provider Business Practice Location Address
First Line	:	5845 COLLEGE AVENUE
Second Line	:	#4
City	:	OAKLAND
State	:	CA
Zip	:	94618-1635
Country	:	US
Telephone Number	:	510-547-2522
Fax Number	:	510-595-3308

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	09/11/2025

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