Healthcare Provider Details
I. General information
NPI: 1871870964
Provider Name (Legal Business Name): MICHELLE NICOLLE HUFSTETLER M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/03/2011
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
124 RIVER RD
SALINAS CA
93908-9601
US
IV. Provider business mailing address
PO BOX 1750
ATASCADERO CA
93423-1750
US
V. Phone/Fax
- Phone: 805-550-3929
- Fax: 805-462-9183
- Phone: 805-550-3929
- Fax: 805-462-9183
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: