Provider Demographics
NPI:1972522084
Name:HYDE, DENNIS (MFT)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:HYDE
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:PO BOX 8827
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-8827
Mailing Address - Country:US
Mailing Address - Phone:530-342-7049
Mailing Address - Fax:530-898-1677
Practice Address - Street 1:270 E 4TH ST
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-5414
Practice Address - Country:US
Practice Address - Phone:530-342-7049
Practice Address - Fax:530-898-1677
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT18381106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist