Provider Demographics
NPI:1407248321
Name:HASBUN, MICHELLE (ASW, PPSC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:HASBUN
Suffix:
Gender:
Credentials:ASW, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 ARISTOTLE ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1706
Mailing Address - Country:US
Mailing Address - Phone:310-678-9819
Mailing Address - Fax:
Practice Address - Street 1:24930 AVENUE STANFORD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1272
Practice Address - Country:US
Practice Address - Phone:661-294-5300
Practice Address - Fax:661-294-7520
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
CA390200000X
CA1104831041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program