Provider Demographics
NPI:1740707355
Name:HUGHES, CLAYTON (LICENSED MFT)
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:LICENSED MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 LYNDELL TER STE 130
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-6205
Mailing Address - Country:US
Mailing Address - Phone:916-426-6567
Mailing Address - Fax:
Practice Address - Street 1:2050 LYNDELL TER STE 130
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-6205
Practice Address - Country:US
Practice Address - Phone:916-426-6567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122815106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist