Provider Demographics
NPI:1790358752
Name:HUGHEY, BRIANNA (CTRS)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:HUGHEY
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8444 ANCHO WAY
Mailing Address - Street 2:
Mailing Address - City:ELVERTA
Mailing Address - State:CA
Mailing Address - Zip Code:95626-9540
Mailing Address - Country:US
Mailing Address - Phone:916-801-8293
Mailing Address - Fax:
Practice Address - Street 1:8444 ANCHO WAY
Practice Address - Street 2:
Practice Address - City:ELVERTA
Practice Address - State:CA
Practice Address - Zip Code:95626-9540
Practice Address - Country:US
Practice Address - Phone:916-801-8293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80242171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator