MEDICARE: DEBORAH M. DUBIN 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	1041C0700X	Clinical Social Worker	LCS15977	CA

General Provider Information

NPI Number	:	1306984786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH M. DUBIN LCSW

Provider Business Mailing Address
First Line	:	28002 DAYDREAM WAY
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91354-1103
Country	:	US
Telephone Number	:	661-210-2905
Fax Number	:

Provider Business Practice Location Address
First Line	:	28494 WESTINGHOUSE PL
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-0930
Country	:	US
Telephone Number	:	661-210-5001
Fax Number	:

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

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	07/08/2007

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