Healthcare Provider Details

I. General information

NPI: 1952096893
Provider Name (Legal Business Name): HUGHES MARRIAGE & FAMILY THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 04/06/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36367 RIDGEVIEW PL
YUCAIPA CA
92399-5808
US

IV. Provider business mailing address

34428 YUCAIPA BLVD STE E-124
YUCAIPA CA
92399-2474
US

V. Phone/Fax

Practice location:
  • Phone: 951-268-2851
  • Fax:
Mailing address:
  • Phone: 951-268-2851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH V HUGHES
Title or Position: LMFT/LMFT
Credential: MASTERS OF SCIENCE
Phone: 951-268-2851