Provider Demographics
NPI:1407880685
Name:MCHUGH, MINDY MARIE (MFT)
Entity Type:Individual
Prefix:MS
First Name:MINDY
Middle Name:MARIE
Last Name:MCHUGH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 CANYON CREST AVE
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-4842
Mailing Address - Country:US
Mailing Address - Phone:925-735-3431
Mailing Address - Fax:925-735-3431
Practice Address - Street 1:12 CROW CANYON CT
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1975
Practice Address - Country:US
Practice Address - Phone:925-855-1320
Practice Address - Fax:925-855-1324
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39852101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health