Healthcare Provider Details
I. General information
NPI: 1518421296
Provider Name (Legal Business Name): MRS. JOANA HUBBARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/26/2019
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4129 STATE ST
SANTA BARBARA CA
93110-1848
US
IV. Provider business mailing address
21900 SHADY CT
TEHACHAPI CA
93561-8858
US
V. Phone/Fax
- Phone: 805-964-4795
- Fax:
- Phone: 661-912-5485
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 9092 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: