Healthcare Provider Details

I. General information

NPI: 1699589507
Provider Name (Legal Business Name): VJ TUTSON MD AND ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 SAN VICENTE BLVD STE 520
LOS ANGELES CA
90048-5455
US

IV. Provider business mailing address

11601 SHADOW CREEK PKWY STE 111-410
PEARLAND TX
77584-7283
US

V. Phone/Fax

Practice location:
  • Phone: 310-482-1846
  • Fax: 737-309-5138
Mailing address:
  • Phone: 310-482-1846
  • Fax: 737-309-5138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: VALERIE TUTSON
Title or Position: CEO/OWNER
Credential: MD
Phone: 310-482-1846