Provider Demographics
NPI:1982745139
Name:HUTTON, PAULINE N (PT)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:N
Last Name:HUTTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7671 GREENHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-4438
Mailing Address - Country:US
Mailing Address - Phone:916-395-5840
Mailing Address - Fax:916-395-5840
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-6700
Practice Address - Fax:916-734-6706
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12636225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist