Provider Demographics
NPI:1558474957
Name:TAYLOR, HUTTON HINSDALE (MFT)
Entity Type:Individual
Prefix:MR
First Name:HUTTON
Middle Name:HINSDALE
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 N SAN PEDRO RD
Mailing Address - Street 2:STE. 2028
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-4188
Mailing Address - Country:US
Mailing Address - Phone:415-499-7587
Mailing Address - Fax:415-499-3267
Practice Address - Street 1:20 N SAN PEDRO RD
Practice Address - Street 2:STE. 2028
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-4188
Practice Address - Country:US
Practice Address - Phone:415-499-7587
Practice Address - Fax:415-499-3267
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 20831106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist