Physician Compare National (NPI:1831279074)

HEALTHCARE PROVIDER: NICOLE MIGNON DUBUS LICSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1831279074
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830281013
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170608001432
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DUBUS
	Individual professional last name
Provider First Name	NICOLE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2006 MISSION ST
	Group Practice or individual's line 1 address
City	SANTA CRUZ
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	950605218
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9783173088
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y