Provider Demographics
NPI:1124241690
Name:DUBIN, DORI OBADIA (PSYD LCSW)
Entity type:Individual
Prefix:DR
First Name:DORI
Middle Name:OBADIA
Last Name:DUBIN
Suffix:
Gender:F
Credentials:PSYD LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5845 COLLEGE AVENUE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1635
Mailing Address - Country:US
Mailing Address - Phone:510-547-2522
Mailing Address - Fax:510-595-3308
Practice Address - Street 1:5845 COLLEGE AVENUE
Practice Address - Street 2:#4
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1635
Practice Address - Country:US
Practice Address - Phone:510-547-2522
Practice Address - Fax:510-595-3308
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS9393102L00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical