Provider Demographics
NPI:1275246886
Name:HUGHES, WALTER III
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:
Last Name:HUGHES
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5568 LEXINGTON AVE APT 214
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-4164
Mailing Address - Country:US
Mailing Address - Phone:510-453-0732
Mailing Address - Fax:
Practice Address - Street 1:1185 PEDRO ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3757
Practice Address - Country:US
Practice Address - Phone:510-453-0732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor