Basic Information
Provider Information
NPI: 1104906239
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUBER
FirstName: KATHERINE
MiddleName: ANN
NamePrefix: DR.
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7244
Address2:  
City: ORANGE
State: CA
PostalCode: 928637244
CountryCode: US
TelephoneNumber: 7149356363
FaxNumber: 7149358112
Practice Location
Address1: 405 W 5TH ST STE 590
Address2:  
City: SANTA ANA
State: CA
PostalCode: 927014519
CountryCode: US
TelephoneNumber: 7148345015
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/16/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000XPSY 16982CAY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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