Healthcare Provider Details

I. General information

NPI: 1487132155
Provider Name (Legal Business Name): DENA HULBERT PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2018
Last Update Date: 08/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15615 ALTON PKWY STE 230
IRVINE CA
92618-7306
US

IV. Provider business mailing address

15615 ALTON PKWY STE 230
IRVINE CA
92618-7306
US

V. Phone/Fax

Practice location:
  • Phone: 949-528-6300
  • Fax: 855-779-3627
Mailing address:
  • Phone: 949-528-6300
  • Fax: 855-779-3627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSB94021558
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: