Provider Demographics
NPI:1144344474
Name:HUBERT, JOHN
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:HUBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 477
Mailing Address - Street 2:
Mailing Address - City:COOL
Mailing Address - State:CA
Mailing Address - Zip Code:95614-0477
Mailing Address - Country:US
Mailing Address - Phone:530-889-7272
Mailing Address - Fax:530-889-7293
Practice Address - Street 1:11512 B AVE
Practice Address - Street 2:ADULT SYSTEM OF CARE
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2605
Practice Address - Country:US
Practice Address - Phone:530-889-7272
Practice Address - Fax:530-889-7293
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health