MEDICARE: KIMBERLEY ANN DUBEAU LMFT

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	106H00000X	Marriage & Family Therapist	MFC46101	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MFC 46101	OTHER	CA	BBS

General Provider Information

NPI Number	:	1144486663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLEY ANN DUBEAU LMFT

Provider Business Mailing Address
First Line	:	74530 FAIRWAY DR
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-4587
Country	:	US
Telephone Number	:	760-880-6242
Fax Number	:

Provider Business Practice Location Address
First Line	:	74075 EL PASEO STE B1
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-4145
Country	:	US
Telephone Number	:	760-880-6242
Fax Number	:

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

Provider Enumeration Date	:	08/04/2008
Last Update Date	:	09/09/2008

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Directions to “ KIMBERLEY ANN DUBEAU LMFT” Practice Location

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