Provider Demographics
NPI:1538920384
Name:HUGHES, JOSEPH MICHAEL (SUDRC #16996)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:HUGHES
Suffix:
Gender:M
Credentials:SUDRC #16996
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 5933
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:CA
Mailing Address - Zip Code:96021-5933
Mailing Address - Country:US
Mailing Address - Phone:530-209-7148
Mailing Address - Fax:
Practice Address - Street 1:3075 VEDA ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-3245
Practice Address - Country:US
Practice Address - Phone:530-244-6800
Practice Address - Fax:530-244-6802
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16996101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)