Provider Demographics
NPI:1144381310
Name:LUTTON, PATRICIA (PT)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:LUTTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:SKELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:10365 ALPINE DR APT C
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-0921
Mailing Address - Country:US
Mailing Address - Phone:408-962-0209
Mailing Address - Fax:
Practice Address - Street 1:1601 S DE ANZA BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-5347
Practice Address - Country:US
Practice Address - Phone:408-257-2225
Practice Address - Fax:408-257-2485
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33275225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist