Provider Demographics
NPI:1114301348
Name:DUBOIS, SHAY LINTON (MSW)
Entity Type:Individual
Prefix:MS
First Name:SHAY
Middle Name:LINTON
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 AGOSTO ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-3608
Mailing Address - Country:US
Mailing Address - Phone:619-862-5295
Mailing Address - Fax:
Practice Address - Street 1:1286 UNIVERSITY AVE # 1020
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3312
Practice Address - Country:US
Practice Address - Phone:858-321-6355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1000491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical