Active NPI
Amie Tishler Dubois, RNP
- Women's Health Nurse Practitioner
- San Mateo, CA
National Provider Identifier
1285838136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 9792
- Practice address
- 222 W 39TH Ave
Keller Center
San Mateo, CA 94403-4364 - Phone
- (650) 573-2646
- NPI assigned
- Jun 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 9792 | CA | Primary |
Addresses
Primary practice location
222 W 39TH Ave
Keller Center
San Mateo, CA 94403-4364
Mailing address
PO Box 371484
Montara, CA 94037-1484
Phone (650) 573-2646
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9792 | CA | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285838136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 371484",
"city": "MONTARA",
"state": "CA",
"postal_code": "940371484",
"telephone_number": "650-573-2646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 W 39TH AVE",
"address_2": "KELLER CENTER",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944034364",
"telephone_number": "650-573-2646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBOIS",
"first_name": "AMIE",
"middle_name": "TISHLER",
"credential": "RNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "CA",
"license": "9792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.