Provider Demographics
NPI:1649610163
Name:VAN HOUTEN, HUNTER C (PT)
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:C
Last Name:VAN HOUTEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2166 N MOORPARK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5011
Mailing Address - Country:US
Mailing Address - Phone:805-370-1020
Mailing Address - Fax:805-370-1022
Practice Address - Street 1:2166 N MOORPARK RD STE 200
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5011
Practice Address - Country:US
Practice Address - Phone:805-370-1020
Practice Address - Fax:805-370-1022
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILO700206192251X0800X
IN225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist