Provider Demographics
NPI:1942499256
Name:DUTTON, WENDY SARAH (JD)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:SARAH
Last Name:DUTTON
Suffix:
Gender:F
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 EAST 31ST ST
Mailing Address - Street 2:ACMC HIGHLAND CAMPUS
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602
Mailing Address - Country:US
Mailing Address - Phone:510-437-4688
Mailing Address - Fax:510-437-8313
Practice Address - Street 1:1411 EAST 31ST ST
Practice Address - Street 2:ACMC HIGHLAND CAMPUS
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602
Practice Address - Country:US
Practice Address - Phone:510-437-4688
Practice Address - Fax:510-437-8313
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker