Healthcare Provider Details

I. General information

NPI: 1225270903
Provider Name (Legal Business Name): KATHERINE ROSE HULBERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2009
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR STE 110
OXNARD CA
93036-2665
US

IV. Provider business mailing address

1580 1ST ST
NAPA CA
94559-2841
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-4200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA113586
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: