Healthcare Provider Details

I. General information

NPI: 1285211011
Provider Name (Legal Business Name): CHRISTIAN LARAY HUTCHINGS PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 WILLOW PASS RD STE 102
CONCORD CA
94520-5225
US

IV. Provider business mailing address

1333 WILLOW PASS RD STE 102
CONCORD CA
94520-5225
US

V. Phone/Fax

Practice location:
  • Phone: 925-825-1793
  • Fax:
Mailing address:
  • Phone: 925-825-1793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberPSB94025624
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPSB94025624
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: