Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | LM427 | CA |
NPI | 1104218593 |
---|---|
Provider Name | Alicia Rose Hubbell |
First Address | Chula Vista, CA 91911-2509 |
Second Address | Chula Vista, CA 91911-2509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2015 |
Last Update Date | 23/02/2015 |