Provider Demographics
NPI:1942048574
Name:HURLEY, TREVOR (LMFT)
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:HURLEY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 SPRINGVIEW PL
Mailing Address - Street 2:
Mailing Address - City:ALTA LOMA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-4893
Mailing Address - Country:US
Mailing Address - Phone:909-262-2556
Mailing Address - Fax:
Practice Address - Street 1:6825 SPRINGVIEW PL
Practice Address - Street 2:
Practice Address - City:ALTA LOMA
Practice Address - State:CA
Practice Address - Zip Code:91701-4893
Practice Address - Country:US
Practice Address - Phone:909-262-2556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA137978106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist