Provider Demographics
NPI:1568913929
Name:HUTCHINSON, CASSANDRA ROSE
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ROSE
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4182 N VIKING WAY
Mailing Address - Street 2:SUITE #202
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1491
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4182 N VIKING WAY
Practice Address - Street 2:SUITE #202
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1491
Practice Address - Country:US
Practice Address - Phone:562-546-5184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor