Provider Demographics
NPI:1932364718
Name:HULEM, REBECCA JANE (NP)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:JANE
Last Name:HULEM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5737 KANAN RD
Mailing Address - Street 2:SUITE 261
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-1601
Mailing Address - Country:US
Mailing Address - Phone:818-425-2886
Mailing Address - Fax:
Practice Address - Street 1:5737 KANAN RD
Practice Address - Street 2:SUITE 261
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-1601
Practice Address - Country:US
Practice Address - Phone:818-425-2886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA269076163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory