Healthcare Provider Details

I. General information

NPI: 1013558089
Provider Name (Legal Business Name): MONETTE HOBURN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 07/07/2023
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 34TH ST STE 100&200
BAKERSFIELD CA
93301-2305
US

IV. Provider business mailing address

625 34TH ST STE 100&200
BAKERSFIELD CA
93301-2305
US

V. Phone/Fax

Practice location:
  • Phone: 833-678-2781
  • Fax:
Mailing address:
  • Phone: 833-678-2781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95013424
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: