Healthcare Provider Details

I. General information

NPI: 1861353682
Provider Name (Legal Business Name): ABIGAIL BROOKE HOBBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 ERTEN ST
THOUSAND OAKS CA
91360-1810
US

IV. Provider business mailing address

676 CAMINO TIERRA SANTA APT 204
CAMARILLO CA
93010-7895
US

V. Phone/Fax

Practice location:
  • Phone: 478-442-0875
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: