Healthcare Provider Details

I. General information

NPI: 1194988527
Provider Name (Legal Business Name): ERIN C HUBBARD PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 N PRAIRIE AVE STE 430
INGLEWOOD CA
90301-4506
US

IV. Provider business mailing address

4760 SEPULVEDA BLVD
CULVER CITY CA
90230-4820
US

V. Phone/Fax

Practice location:
  • Phone: 310-677-7808
  • Fax:
Mailing address:
  • Phone: 310-390-6612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY24501
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: