Susan L Dubin-McNeil, EDD

Individual provider Active NPI Psychologist · PT Reyes, CA

NPI 1083779599 · NPPES record last updated Apr 6, 2011

Key facts

NPI
1083779599
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
PSY12018 (CA)
Practice address
100 6TH St PT Reyes
PT Reyes, CA 94956
Phone
(415) 663-8231
Fax
(415) 473-3828
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PSY12018CAMDPsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY12018 CA Yes

Addresses

Primary practice location

100 6TH St PT Reyes
PT Reyes, CA 94956

Mailing address

PO Box 331
West Marin Health and Human Services
Point Reyes Station, CA 94956-0331
Phone (415) 663-8231

Other names

  • Dr. Susan L Dubin-McNeil Professional name

Sources for this page

Verify at the official NPI Registry.