Provider Demographics
NPI:1154481067
Name:HUITRIC, ALBERT ALLAN (MS)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:ALLAN
Last Name:HUITRIC
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2891 CHURN CREEK RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1148
Mailing Address - Country:US
Mailing Address - Phone:530-226-1634
Mailing Address - Fax:
Practice Address - Street 1:2891 CHURN CREEK RD
Practice Address - Street 2:SUITE B
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1148
Practice Address - Country:US
Practice Address - Phone:530-226-1634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23973106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA23973OtherMFT