SAMANTHA DUBOSE
NPI 1871957365
Marriage & Family Therapist in Modesto, CA

Q: What is Samantha Dubose's NPI number?

The NPI number for Samantha Dubose is 1871957365. It was assigned to this individual provider in the NPPES registry on April 11, 2016.

Q: What is Samantha Dubose's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Dubose was last updated on November 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 11, 2016PECOS Enrolled

5815 STODDARD RD STE 600, MODESTO, CA 95356(209) 543-1874(209) 543-1869 Get Directions Write a Review

NPPES record last updated: November 19, 2020. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Nov 19, 2020, Mar 17, 2018, Dec 26, 2017 (3 updates tracked since 2017).

On this page

About Samantha Dubose NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA DUBOSE (NPI 1871957365) is an individual marriage & family therapist in Modesto, California, licensed in California (117273) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Modesto, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1871957365

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameSAMANTHA DUBOSE

Location Address5815 STODDARD RD STE 600Modesto, CA 95356-9041

Mailing Address5815 Stoddard Rd Ste 600Modesto, CA 95356-9041 · (209) 543-1874 · Fax (209) 543-1869

Phone(209) 543-1874

Fax(209) 543-1869

Sole ProprietorYes

Medical School CMSOtherGraduated 2016

Enumeration DateApril 11, 2016

Last NPPES UpdateNovember 19, 20203 updates tracked since enumeration

NPPES CertifiedNovember 19, 2020

✔ NPI 1871957365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 117273

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

5815 STODDARD RD STE 600, Modesto, CA 95356

Open in Google Maps ↗

Secondary Practice Location 1

Location 1101 Poplar AveModesto, CA 95354-0509 · Phone (209) 550-5869

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Dubose is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID345724738

PECOS Enrollment IDI20260324002761

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELISA AILEEN GONZALEZ

Marriage & Family Therapist