Dynasty Huckleby

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

582 Market St Ste 1608
San Francisco, CA 94104-5317

Phone

(833) 931-1716

NPI assigned

Aug 11, 2020

Last updated

Apr 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Marriage and Family Therapist

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Well Coast Psychiatric Inc. a Nursing Corp

  dba Celium Healthcare

  • Psychiatry Physician
  • Tigard, OR
  • NPI 1841784725
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1225649437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 MARKET ST STE 1608",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941045317",
            "telephone_number": "833-931-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 MARKET ST STE 1608",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941045317",
            "telephone_number": "833-931-1716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 Bristol St",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926265981",
            "country_code": "US",
            "telephone_number": "833-931-1716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4295 Gesner St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921176646",
            "country_code": "US",
            "telephone_number": "833-931-1716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6080 Center Dr",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900459209",
            "country_code": "US",
            "telephone_number": "833-931-1716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUCKLEBY",
        "first_name": "DYNASTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark W Huber, APRN
• Richard R. Huber, LVN
• Sophia Huber
• Megan Justine Huchko, MD
• Huckleberry Youth Programs, Inc
• Naureen Huda, MD
• Regina Marie Hudak, PA-C
• Heather G. Huddleston, M.D.
• Lindsey Huddleston, M.D.
• Lauren Hudec

• Marriage & Family Therapist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.