Healthcare Provider Details

I. General information

NPI: 1922926773
Provider Name (Legal Business Name): WILL HUBERT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 WILSON AVE
NOVATO CA
94947-3825
US

IV. Provider business mailing address

PO BOX 754
FOREST KNOLLS CA
94933-0754
US

V. Phone/Fax

Practice location:
  • Phone: 415-892-1643
  • Fax:
Mailing address:
  • Phone: 415-259-8669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: