Healthcare Provider Details

I. General information

NPI: 1487367892
Provider Name (Legal Business Name): KIMBERLY M HUBBARD ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2022
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5318 E 2ND ST # 4099
LONG BEACH CA
90803-5324
US

IV. Provider business mailing address

5941 CALIFORNIA AVE SW APT 103
SEATTLE WA
98136-1665
US

V. Phone/Fax

Practice location:
  • Phone: 424-259-3644
  • Fax:
Mailing address:
  • Phone: 310-855-2636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number137664
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number20938
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: