Provider Demographics
NPI:1598013328
Name:DUBOIS, DEVON JANE (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DEVON
Middle Name:JANE
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 CAMINO DEL RIO S
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3825
Mailing Address - Country:US
Mailing Address - Phone:858-333-7647
Mailing Address - Fax:
Practice Address - Street 1:2835 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3825
Practice Address - Country:US
Practice Address - Phone:858-333-7647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87052106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist