Healthcare Provider Details

I. General information

NPI: 1407248321
Provider Name (Legal Business Name): MICHELLE HASBUN ASW, PPSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24930 AVENUE STANFORD
VALENCIA CA
91355-1272
US

IV. Provider business mailing address

327 ARISTOTLE ST
SIMI VALLEY CA
93065-1706
US

V. Phone/Fax

Practice location:
  • Phone: 661-294-5300
  • Fax: 661-294-7520
Mailing address:
  • Phone: 310-678-9819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number110483
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: