MEDICARE: MARISSA M HULBERT

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	106H00000X	Marriage & Family Therapist	148337	CA

General Provider Information

NPI Number	:	1801557384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA M HULBERT

Provider Business Mailing Address
First Line	:	555 N PERRIS BLVD BLDG A
Second Line	:
City	:	PERRIS
State	:	CA
Zip	:	92571-2811
Country	:	US
Telephone Number	:	951-436-5300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 E COOLEY DR
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-3905
Country	:	US
Telephone Number	:	909-580-3705
Fax Number	:	909-580-3747

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

Provider Enumeration Date	:	01/06/2022
Last Update Date	:	06/05/2026

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Directions to “ MARISSA M HULBERT ” Practice Location

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