Provider Demographics
NPI:1104976281
Name:HYLTON, JEFFREY ALLEN (LCSW)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ALLEN
Last Name:HYLTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 EDNA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-2607
Mailing Address - Country:US
Mailing Address - Phone:650-342-3078
Mailing Address - Fax:650-341-7935
Practice Address - Street 1:100 S. ELLSWORTH AVENUE
Practice Address - Street 2:SUITE 511
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2847
Practice Address - Country:US
Practice Address - Phone:650-342-3078
Practice Address - Fax:650-341-7935
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 78661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical