Provider Demographics
NPI:1053091603
Name:TRELLES HUESO, MARCELA
Entity type:Individual
Prefix:
First Name:MARCELA
Middle Name:
Last Name:TRELLES HUESO
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 1:285 MERCEY SPRINGS RD STE E
Mailing Address - Street 2:
Mailing Address - City:LOS BANOS
Mailing Address - State:CA
Mailing Address - Zip Code:93635-3878
Mailing Address - Country:US
Mailing Address - Phone:209-725-2125
Mailing Address - Fax:
Practice Address - Street 1:285 MERCEY SPRINGS RD STE E
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-3878
Practice Address - Country:US
Practice Address - Phone:209-725-2125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor