=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598013328
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEVON JANE DUBOIS M.A., LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2012
-----------------------------------------------------
Last Update Date | 08/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12396 WORLD TRADE DR STE 109
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92128-3787
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-333-7647
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12396 WORLD TRADE DR STE 109
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92128-3787
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-333-7647
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 87052
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------