Healthcare Provider Details

I. General information

NPI: 1740015395
Provider Name (Legal Business Name): DANIELLE MARIE HUBER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2885 CHURN CREEK RD STE A
REDDING CA
96002-1147
US

IV. Provider business mailing address

3400 BECHELLI LN STE E
REDDING CA
96002-2466
US

V. Phone/Fax

Practice location:
  • Phone: 530-221-6303
  • Fax:
Mailing address:
  • Phone: 530-410-8463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95032008
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: