| Shane P Hutton Phd A Professional Psychologist Corporation | |
|
9444 Reverie Rd Tujunga CA 91042-3024 | |
| (818) 569-9440 | |
| Not Available |
| Full Name | Shane P Hutton Phd A Professional Psychologist Corporation |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 9444 Reverie Rd, Tujunga, California |
| Authorized Official Name and Position | Shane P Hutton (PROVIDER/PRESIDENT) |
| Authorized Official Contact | 8185699440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shane P Hutton Phd A Professional Psychologist Corporation 9444 Reverie Rd Tujunga CA 91042-3024 Ph: () - | Shane P Hutton Phd A Professional Psychologist Corporation 9444 Reverie Rd Tujunga CA 91042-3024 Ph: (818) 569-9440 |
| NPI Number | 1841662772 |
|---|---|
| Provider Enumeration Date | 10/30/2015 |
| Last Update Date | 10/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841662772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY23919 (California) | Primary |
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