Provider Demographics
NPI:1881926301
Name:HUTTON, HANNELORE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:HANNELORE
Middle Name:
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 1:8618 S SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-4005
Mailing Address - Country:US
Mailing Address - Phone:310-216-7109
Mailing Address - Fax:310-645-0322
Practice Address - Street 1:8618 S SEPULVEDA BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-4005
Practice Address - Country:US
Practice Address - Phone:310-216-7109
Practice Address - Fax:310-645-0322
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21520106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist