Healthcare Provider Details

I. General information

NPI: 1639061138
Provider Name (Legal Business Name): HUBBERT HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2242 9TH AVE
OAKLAND CA
94606-2614
US

IV. Provider business mailing address

22 MOSS AVE APT 203
OAKLAND CA
94610-1354
US

V. Phone/Fax

Practice location:
  • Phone: 510-221-0444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: BENEDICT A HUBBERT
Title or Position: CEO
Credential:
Phone: 650-906-8620