Provider Demographics
NPI:1184020265
Name:HURLBERT, THERON
Entity type:Individual
Prefix:MR
First Name:THERON
Middle Name:
Last Name:HURLBERT
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 950
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-0950
Mailing Address - Country:US
Mailing Address - Phone:530-528-2938
Mailing Address - Fax:530-528-8024
Practice Address - Street 1:2608 VICTOR AVE STE A
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1447
Practice Address - Country:US
Practice Address - Phone:530-722-1022
Practice Address - Fax:530-722-1058
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor