Provider Demographics
NPI:1740988534
Name:HUTCHINSON, MONICA DEANNE (SUDRT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:DEANNE
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:SUDRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 GIBSON DR APT 2116
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5734
Mailing Address - Country:US
Mailing Address - Phone:831-214-6608
Mailing Address - Fax:
Practice Address - Street 1:ENCOMPASS COMMUNITY SERVICES
Practice Address - Street 2:380 ENCINAL STREET, STE. 200
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060
Practice Address - Country:US
Practice Address - Phone:831-469-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13573101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)