Provider Demographics
NPI:1104957802
Name:HUKILL-BUCK, JUANITA MARGARET
Entity type:Individual
Prefix:MS
First Name:JUANITA
Middle Name:MARGARET
Last Name:HUKILL-BUCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21030 MISSION ST STE A
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-6769
Mailing Address - Country:US
Mailing Address - Phone:661-822-8979
Mailing Address - Fax:
Practice Address - Street 1:21031 MISSION ST
Practice Address - Street 2:SUITE A
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561
Practice Address - Country:US
Practice Address - Phone:661-822-8979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 70015106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist