Provider Demographics
NPI:1760154504
Name:HUTSON, CALI (DROT, OTR/L, CTRS)
Entity Type:Individual
Prefix:
First Name:CALI
Middle Name:
Last Name:HUTSON
Suffix:
Gender:F
Credentials:DROT, OTR/L, CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 LINCOLN VILLAGE CIR APT 2261
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1653
Mailing Address - Country:US
Mailing Address - Phone:571-438-2423
Mailing Address - Fax:
Practice Address - Street 1:3100 NORIEGA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-4046
Practice Address - Country:US
Practice Address - Phone:650-731-5439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22689225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics