Provider Demographics
NPI:1326204702
Name:TUTTLE, RAZAN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:RAZAN
Middle Name:
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:RAZAN
Other - Middle Name:
Other - Last Name:RETIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1895 TAHOE CIR
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-8920
Mailing Address - Country:US
Mailing Address - Phone:925-980-0413
Mailing Address - Fax:
Practice Address - Street 1:2180 W GRANT LINE RD
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-7309
Practice Address - Country:US
Practice Address - Phone:209-814-4644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
CA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional