Provider Demographics
NPI:1528409919
Name:HUERTA, SALLY KAY (MA)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:KAY
Last Name:HUERTA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10857
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93912-7857
Mailing Address - Country:US
Mailing Address - Phone:831-596-6125
Mailing Address - Fax:
Practice Address - Street 1:306 CAPITOL ST STE 205
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2604
Practice Address - Country:US
Practice Address - Phone:831-596-6125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-13
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104645106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist