Provider Demographics
NPI:1093913949
Name:HULUGALLE, CERI M (MFT)
Entity Type:Individual
Prefix:MS
First Name:CERI
Middle Name:M
Last Name:HULUGALLE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:CERI
Other - Middle Name:M
Other - Last Name:DON MICHAEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:393 E WALNUT ST
Mailing Address - Street 2:3RD FLOOR - PHR SYSTEMS
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91188-0001
Mailing Address - Country:US
Mailing Address - Phone:626-405-7914
Mailing Address - Fax:626-405-6768
Practice Address - Street 1:3733 SAN DIMAS ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1407
Practice Address - Country:US
Practice Address - Phone:800-353-5400
Practice Address - Fax:626-405-6768
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40951106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist