Healthcare Provider Details

I. General information

NPI: 1750254835
Provider Name (Legal Business Name): JODI HUTCHINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2025
Last Update Date: 10/24/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3591 CERRITOS AVE
LOS ALAMITOS CA
90720-2414
US

IV. Provider business mailing address

3591 CERRITOS AVE
LOS ALAMITOS CA
90720-2485
US

V. Phone/Fax

Practice location:
  • Phone: 562-799-4780
  • Fax:
Mailing address:
  • Phone: 562-799-4780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number240283465
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: