Provider Demographics
NPI:1649741570
Name:HUBERG, TRINA JO
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:JO
Last Name:HUBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N BROOKHURST ST STE 306
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5204
Mailing Address - Country:US
Mailing Address - Phone:714-948-7970
Mailing Address - Fax:
Practice Address - Street 1:501 N BROOKHURST ST STE 306
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5204
Practice Address - Country:US
Practice Address - Phone:714-948-7970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist