MEDICARE: THE DUBNOFF CENTER FOR CHILD DEVELOPMENT

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	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932238862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE DUBNOFF CENTER FOR CHILD DEVELOPMENT

Provider Business Mailing Address
First Line	:	10526 DUBNOFF WAY
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-3921
Country	:	US
Telephone Number	:	818-755-4950
Fax Number	:	818-752-0783

Provider Business Practice Location Address
First Line	:	11631 VICTORY BLVD STE 207
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-3572
Country	:	US
Telephone Number	:	818-558-6955
Fax Number	:	818-972-2810

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	SANDRA H STERNIG-BABCOCK
Credential	:	PH.D.
Telephone Number	:	818-755-4950

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	10/22/2010

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Directions to “THE DUBNOFF CENTER FOR CHILD DEVELOPMENT ” Practice Location

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