Provider Demographics
NPI:1932905189
Name:HURLBURT, KALEENA OPDYKE
Entity type:Individual
Prefix:
First Name:KALEENA
Middle Name:OPDYKE
Last Name:HURLBURT
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 1:2085 MENDOCINO ST
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:CA
Mailing Address - Zip Code:93955-3320
Mailing Address - Country:US
Mailing Address - Phone:415-200-7605
Mailing Address - Fax:
Practice Address - Street 1:2085 MENDOCINO ST
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955-3320
Practice Address - Country:US
Practice Address - Phone:415-200-7605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer