Tephanie Doubi, MT,CLT,LLCC

Primary specialty

SpecialistTaxonomy code 174400000X

License

KT12101681 Issued in CA

Practice address

14500 Roscoe Blvd
4TH Floor
Panorama City, CA 91402-4190

Phone

(818) 561-6098

Fax

(818) 890-6692

NPI assigned

Jun 2, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307145600000",
    "number": "1740574102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913410064",
            "telephone_number": "818-554-9668",
            "fax_number": "818-890-6692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 ROSCOE BLVD",
            "address_2": "4TH FLOOR",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024190",
            "telephone_number": "818-561-6098",
            "fax_number": "818-890-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUBI",
        "first_name": "TEPHANIE",
        "name_prefix": "Ms.",
        "credential": "MT,CLT,LLCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "KT12101681",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "KT12101681",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "17132",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Panorama City, CA
• Providers in Panorama City, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.