MEDICARE: GINGER HULST DNP, NP-C, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	5780	HI
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	95006140	CA
3	363LF0000X	Family Nurse Practitioner	95006140	CA
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95006140	CA
5	363LF0000X	Family Nurse Practitioner	5780	HI

General Provider Information

NPI Number	:	1740728831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINGER HULST DNP, NP-C, PMHNP-BC

Provider Business Mailing Address
First Line	:	10650 REAGAN ST UNIT 824
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-8844
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 S PACIFIC COAST HWY STE 200D
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5611
Country	:	US
Telephone Number	:	310-698-5252
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2017
Last Update Date	:	03/05/2026

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