Provider Demographics
NPI:1740454941
Name:TOTTON, CARL ALLEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:ALLEN
Last Name:TOTTON
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 1:10630 BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-2511
Mailing Address - Country:US
Mailing Address - Phone:818-760-4219
Mailing Address - Fax:
Practice Address - Street 1:10630 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-2511
Practice Address - Country:US
Practice Address - Phone:818-760-4219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17547103TC0700X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth