Healthcare Provider Details

I. General information

NPI: 1881587863
Provider Name (Legal Business Name): MICHELLE MIGNON HULL PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 EL CAMINO REAL STE 120
MENLO PARK CA
94025-4884
US

IV. Provider business mailing address

1838 GOLDEN GATE AVE
SAN FRANCISCO CA
94115-4311
US

V. Phone/Fax

Practice location:
  • Phone: 650-204-1246
  • Fax:
Mailing address:
  • Phone: 512-810-2128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: