Elissa Rose Dubois, BCBA, M.S

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-25978

Practice address

1650 Freda LN
Cardiff by the Sea, CA 92007-1107

Phone

(626) 390-3759

NPI assigned

Oct 20, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Elissa Rose Leibl Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Reach Therapy, Inc.

  • Behavior Analyst
  • Carlsbad, CA
  • NPI 1326600933
  NPD Authorized official

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1902278757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 FREDA LN",
            "city": "CARDIFF BY THE SEA",
            "state": "CA",
            "postal_code": "920071107",
            "telephone_number": "626-390-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 FREDA LN",
            "city": "CARDIFF BY THE SEA",
            "state": "CA",
            "postal_code": "920071107",
            "telephone_number": "626-390-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "ELISSA",
        "middle_name": "ROSE",
        "credential": "BCBA, M.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-20",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-17-25978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISSA",
            "last_name": "LEIBL",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard Fell Carpenter, NP-C
• Christine Gonzales Castro, DMD
• Morgan Page Clancy, APCC
• Clearfast, Inc
• Comprehensive Human Services Inc.
• Daniel Abraham Duel, MD
• Johnnie Edwin Durbin
• Angela Dawn Eastvold, PHD
• Evan Eropkin
• Brian Finn, ATC

• Behavior Analyst in Cardiff by the Sea, CA
• Providers in Cardiff by the Sea, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.