Healthcare Provider Details

I. General information

NPI: 1114864790
Provider Name (Legal Business Name): JENNIFER HUBBS MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 MOOSEHEAD DR
APTOS CA
95003-4555
US

IV. Provider business mailing address

361 MOOSEHEAD DR
APTOS CA
95003-4555
US

V. Phone/Fax

Practice location:
  • Phone: 831-359-7502
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW22587
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: