MEDICARE: PATRICIA HUBER LCSW MSW PPS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS21064	CA

General Provider Information

NPI Number	:	1386742609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA HUBER LCSW MSW PPS

Provider Business Mailing Address
First Line	:	PO BOX 334
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-0334
Country	:	US
Telephone Number	:	714-754-6505
Fax Number	:

Provider Business Practice Location Address
First Line	:	13001 SEAL BEACH BLVD STE 360
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-2747
Country	:	US
Telephone Number	:	714-754-6505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	03/08/2021

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