Basic Information
| Provider Information | |||||||||
| NPI: | 1326389206 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUBLINO | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA,BA,AA,CATAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1060 S BROOKHURST RD | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928333709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144491339 | ||||||||
| FaxNumber: | 7144491289 | ||||||||
| Practice Location | |||||||||
| Address1: | 1060 S BROOKHURST RD | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928333709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144491339 | ||||||||
| FaxNumber: | 7144491289 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2013 | ||||||||
| LastUpdateDate: | 03/02/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 112494 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.