Provider Demographics
NPI:1013308253
Name:HUGHES, ELISA ELIZABETH (MA, MFT)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:ELIZABETH
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:ELISA
Other - Middle Name:ELIZABETH
Other - Last Name:DANSIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1868 CLAYTON RD
Mailing Address - Street 2:SUITE 126
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2547
Mailing Address - Country:US
Mailing Address - Phone:925-609-8448
Mailing Address - Fax:925-609-7222
Practice Address - Street 1:1868 CLAYTON RD
Practice Address - Street 2:SUITE 126
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2547
Practice Address - Country:US
Practice Address - Phone:925-609-8448
Practice Address - Fax:925-609-7222
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT84286106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist