Healthcare Provider Details

I. General information

NPI: 1841785839
Provider Name (Legal Business Name): VIRGINIA HUFF LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 S ORCHARD AVE STE C230
VACAVILLE CA
95688-3657
US

IV. Provider business mailing address

PO BOX 5962
NAPA CA
94581-0962
US

V. Phone/Fax

Practice location:
  • Phone: 707-372-3612
  • Fax:
Mailing address:
  • Phone: 707-372-3612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number79949
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: