Provider Demographics
NPI:1275106890
Name:HUTCHINS, MARISSA ASHLEY (HAD)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:ASHLEY
Last Name:HUTCHINS
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 WARD ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3032
Mailing Address - Country:US
Mailing Address - Phone:650-984-0495
Mailing Address - Fax:
Practice Address - Street 1:1260 A ST STE 100
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-2961
Practice Address - Country:US
Practice Address - Phone:510-538-8884
Practice Address - Fax:510-538-5144
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8605237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist