Provider Demographics
NPI:1295859759
Name:HUTTON, ANGELA M (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:HUTTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 DELL AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-2711
Mailing Address - Country:US
Mailing Address - Phone:720-939-7183
Mailing Address - Fax:
Practice Address - Street 1:200 S SANTA CRUZ AVE STE 200
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030
Practice Address - Country:US
Practice Address - Phone:415-763-7919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9925311041C0700X
MI68010895691041C0700X
CA271881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical