JONATHAN MICHAEL DUBOS
NPI 1174930085
Psychologist - Clinical Child & Adolescent in San Rafael, CA
NPI Status: Active since July 14, 2014
Contact Information
111 SMITH RANCH RD
SAN RAFAEL, CA
ZIP 94903
Phone: (415) 491-3000
- Individual
- Male
- Psychologist
- Clinical Child & Adolescent
- PECOS Enrolled
About JONATHAN DUBOS
This page provides the complete NPI Profile along with additional information for Jonathan Dubos, a provider established in San Rafael, California with a medical specialization in Psychologist, focusing in clinical child & adolescent . The healthcare provider is registered in the NPI registry with number 1174930085 assigned on July 2014. The practitioner's primary taxonomy code is 103TC2200X with license number PSY33913 (CA). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1174930085
- Provider Name
- JONATHAN MICHAEL DUBOS
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 111 SMITH RANCH RD SAN RAFAEL, CA 94903
- Location Phone
- (415) 491-3000
- Mailing Address
- 524 RELIANT WAY AMERICAN CANYON, CA 94503
- Mailing Phone
- (310) 966-7767
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-14-2014
- Last Update Date
- 04-10-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Clinical Child & Adolescent
- Taxonomy Code
- 103TC2200X
- Type
- Behavioral Health & Social Service Providers
- License No.
- PSY33913
- License State
- CA
- Taxonomy Description
- A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | |
| 2 | 172V00000X | Other Service Providers | Community Health Worker | |
| 3 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Medicare Participation & PECOS Enrollment Status
Jonathan Dubos is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1174930085, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SAN RAFAEL, CA 94903
SAN RAFAEL, CA 94903
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174930085, enumerated as an "individual" on July 14, 2014.
The provider is located at 111 SMITH RANCH RD SAN RAFAEL, CA 94903 and the phone number is (415) 491-3000.
Psychologist with taxonomy code 103TC2200X and a focus in Clinical Child & Adolescent.
