Healthcare Provider Details

I. General information

NPI: 1134834807
Provider Name (Legal Business Name): TONI HULEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 09/15/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 E 6TH ST
LONG BEACH CA
90802-1402
US

IV. Provider business mailing address

PO BOX 41472
LONG BEACH CA
90853-1472
US

V. Phone/Fax

Practice location:
  • Phone: 562-435-7350
  • Fax:
Mailing address:
  • Phone: 562-380-0154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: