Provider Demographics
NPI:1255513958
Name:HUBBARD, EVELYN FRANCES
Entity type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:FRANCES
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FRANKIE
Other - Middle Name:
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4840 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-5705
Mailing Address - Country:US
Mailing Address - Phone:951-662-3204
Mailing Address - Fax:
Practice Address - Street 1:6848 MAGNOLIA AVE
Practice Address - Street 2:STE 200
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2857
Practice Address - Country:US
Practice Address - Phone:951-341-8830
Practice Address - Fax:951-682-2561
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health