Provider Demographics
NPI:1831275858
Name:COUTURE, EUGENE THOMAS (PHD)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:THOMAS
Last Name:COUTURE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 WESTWIND DR
Mailing Address - Street 2:SUITE 407
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3032
Mailing Address - Country:US
Mailing Address - Phone:661-324-2792
Mailing Address - Fax:661-324-0485
Practice Address - Street 1:1800 WESTWIND DR
Practice Address - Street 2:SUITE 407
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3055
Practice Address - Country:US
Practice Address - Phone:661-324-2792
Practice Address - Fax:661-324-0485
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 8108103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPS0081080Medicaid
CAPS0081080Medicaid