Provider Demographics
NPI:1184833865
Name:HUTTON, DOUGLAS H (PSYD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:H
Last Name:HUTTON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 5193
Mailing Address - Street 2:
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90296
Mailing Address - Country:US
Mailing Address - Phone:310-766-7799
Mailing Address - Fax:310-546-4548
Practice Address - Street 1:2100 N SEPULVEDA BLVD
Practice Address - Street 2:SUITE #26
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266
Practice Address - Country:US
Practice Address - Phone:310-766-7799
Practice Address - Fax:310-546-4548
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT40100102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst