Provider Demographics
NPI:1073531414
Name:HUGHES, SUZANNE MARIE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:MARIE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:MARIE
Other - Last Name:BUDRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1510 FASHION ISLAND BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94404-1596
Mailing Address - Country:US
Mailing Address - Phone:415-860-1475
Mailing Address - Fax:
Practice Address - Street 1:1510 FASHION ISLAND BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94404-1596
Practice Address - Country:US
Practice Address - Phone:415-860-1475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 35321106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist