Healthcare Provider Details

I. General information

NPI: 1417581711
Provider Name (Legal Business Name): ANDREA M KULBERG, PHD CLINICAL PSYCHOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3585 MAPLE ST STE 277
VENTURA CA
93003-9146
US

IV. Provider business mailing address

1187 COAST VILLAGE RD # 1-375
SANTA BARBARA CA
93108-2737
US

V. Phone/Fax

Practice location:
  • Phone: 805-729-0180
  • Fax:
Mailing address:
  • Phone: 805-729-0180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREA M KULBERG
Title or Position: OWNER
Credential: PHD
Phone: 970-309-1160