Provider Demographics
NPI:1235513573
Name:HUGHES, KAYLENE
Entity type:Individual
Prefix:
First Name:KAYLENE
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 565
Mailing Address - Street 2:
Mailing Address - City:BIG BEAR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92314-0565
Mailing Address - Country:US
Mailing Address - Phone:909-567-8933
Mailing Address - Fax:
Practice Address - Street 1:32765 HILLTOP BLVD
Practice Address - Street 2:UNIT D & E
Practice Address - City:RUNNING SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92314
Practice Address - Country:US
Practice Address - Phone:909-939-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health