Provider Demographics
NPI:1033664495
Name:HUTCHINS, CONSTANCE (PT, DPT, OCS, FAFS)
Entity Type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:
Last Name:HUTCHINS
Suffix:
Gender:F
Credentials:PT, DPT, OCS, FAFS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6649 AMETHYST AVE UNIT 9556
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-1573
Mailing Address - Country:US
Mailing Address - Phone:909-206-5682
Mailing Address - Fax:
Practice Address - Street 1:5812 COUSINS PL
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91737-2159
Practice Address - Country:US
Practice Address - Phone:909-206-5682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291872225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist