| The Paved Road | |
|
4060 Campus Dr Suite 110 Newport Beach CA 92660-2217 | |
| (949) 399-1111 | |
| Not Available |
| Full Name | The Paved Road |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4060 Campus Dr, Newport Beach, California |
| Authorized Official Name and Position | Douglas J Hutchinson (PARTNER) |
| Authorized Official Contact | 9493991111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Paved Road 4060 Campus Dr Suite 110 Newport Beach CA 92660-2217 Ph: (949) 399-1111 | The Paved Road 4060 Campus Dr Suite 110 Newport Beach CA 92660-2217 Ph: (949) 399-1111 |
| NPI Number | 1700124484 |
|---|---|
| Provider Enumeration Date | 01/30/2013 |
| Last Update Date | 01/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700124484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | LMFT 47859 (California) | Primary |
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