Provider Demographics
NPI:1407246036
Name:HUPP, RICK (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:HUPP
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:RODNEY
Other - Last Name:HUPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:23801 HAYNES ST
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-3103
Mailing Address - Country:US
Mailing Address - Phone:818-822-6644
Mailing Address - Fax:
Practice Address - Street 1:23801 HAYNES ST
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-3103
Practice Address - Country:US
Practice Address - Phone:818-822-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78320106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA78320OtherBBS