Provider Demographics
NPI:1780238691
Name:HUTTON, ALICIA MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:MARIE
Last Name:HUTTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22431 ANTONIO PKWY B160 #637
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-8580
Mailing Address - Country:US
Mailing Address - Phone:949-632-5726
Mailing Address - Fax:949-284-1626
Practice Address - Street 1:27401 LOS ALTOS STE 120
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-8580
Practice Address - Country:US
Practice Address - Phone:562-431-8822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114668106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist