Provider Demographics
NPI:1588982789
Name:HUBBARD, SYBIL M (MSW LCSW)
Entity type:Individual
Prefix:
First Name:SYBIL
Middle Name:M
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:MSW LCSW
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 4304
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93403-4304
Mailing Address - Country:US
Mailing Address - Phone:619-210-9395
Mailing Address - Fax:
Practice Address - Street 1:668 MARSH ST STE 1
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3931
Practice Address - Country:US
Practice Address - Phone:805-888-9343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS259841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical