Provider Demographics
NPI:1912592676
Name:DURBY, JILL
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:DURBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WHISTLING ISLE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5459
Mailing Address - Country:US
Mailing Address - Phone:858-335-1635
Mailing Address - Fax:
Practice Address - Street 1:1600 DOVE ST STE 325
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1418
Practice Address - Country:US
Practice Address - Phone:949-391-9921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty