=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952096893
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUGHES MARRIAGE & FAMILY THERAPY INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2023
-----------------------------------------------------
Last Update Date | 04/06/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 36367 RIDGEVIEW PL
-----------------------------------------------------
City | YUCAIPA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92399-5808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-268-2851
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 34428 YUCAIPA BLVD STE E-124
-----------------------------------------------------
City | YUCAIPA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92399-2474
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-268-2851
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LMFT/LMFT
-----------------------------------------------------
Name | ELIZABETH V HUGHES
-----------------------------------------------------
Credential | MASTERS OF SCIENCE
-----------------------------------------------------
Telephone | 951-268-2851
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------