Provider Demographics
NPI:1740786284
Name:HUTPUTTANASIN, KRISTY LEU (NP)
Entity Type:Individual
Prefix:MS
First Name:KRISTY
Middle Name:LEU
Last Name:HUTPUTTANASIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1010 W LA VETA AVE STE 360
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4300
Mailing Address - Country:US
Mailing Address - Phone:714-245-0492
Mailing Address - Fax:714-245-0494
Practice Address - Street 1:1010 W LA VETA AVE STE 360
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4300
Practice Address - Country:US
Practice Address - Phone:714-245-0492
Practice Address - Fax:714-245-0494
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA818199163W00000X
CA95008450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse