MEDICARE: MRS. MARY PAULETTE HUFFER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker
2	104100000X	Social Worker
3	373H00000X	Day Training/Habilitation Specialist
4	175T00000X	Peer Specialist	MPSS-YUEQCW	CA

General Provider Information

NPI Number	:	1548488752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY PAULETTE HUFFER

Provider Business Mailing Address
First Line	:	2615 S MILLER ST STE 106
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93455-1775
Country	:	US
Telephone Number	:	805-407-4059
Fax Number	:	805-639-8092

Provider Business Practice Location Address
First Line	:	1722 S LEWIS RD
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-8520
Country	:	US
Telephone Number	:	805-928-8622
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	04/21/2026

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