Active NPI
Paul George Dubin, PHD
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1053847574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY16007
- Practice address
- 1200 Gough Street
Suite 200
San Francisco, CA 94109 - Phone
- (415) 440-5095
- Fax
- (415) 771-5655
- NPI assigned
- May 3, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY16007 | CA | |
| Clinical Psychologist | 103TC0700X | PSY16007 | CA | Primary |
Addresses
Primary practice location
1200 Gough Street
Suite 200
San Francisco, CA 94109
Mailing address
1200 Gough Street
Suite 200
San Francisco, CA 94109
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY16007 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493769600000",
"number": "1053847574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 GOUGH STREET",
"address_2": "SUITE 200",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 GOUGH STREET",
"address_2": "SUITE 200",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94109",
"telephone_number": "415-440-5095",
"fax_number": "415-771-5655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBIN",
"first_name": "PAUL",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-03",
"last_updated": "2017-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY16007",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY16007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.