Provider Demographics
NPI:1447834585
Name:HAUBER, KENTON KASEY
Entity type:Individual
Prefix:
First Name:KENTON
Middle Name:KASEY
Last Name:HAUBER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 HOLLISTER AVE STE A3
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2326
Mailing Address - Country:US
Mailing Address - Phone:805-681-7322
Mailing Address - Fax:805-681-5072
Practice Address - Street 1:5350 HOLLISTER AVE STE A3
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2326
Practice Address - Country:US
Practice Address - Phone:805-681-7322
Practice Address - Fax:805-681-5072
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty