Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A84829 | CA |
N | 208600000X | Surgeon | A84829 | CA |
N | 2086S0102X | Surgical Critical Care | A84829 | CA |
Y | 2086S0127X | Trauma Surgeon | A84829 | CA |
NPI | 1255519583 |
---|---|
Provider Name | Jennifer Louise Hubbard |
First Address | Fresno, CA 93721-1431 |
Second Address | Fresno, CA 93701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2008 |
Last Update Date | 11/06/2014 |