Healthcare Provider Details

I. General information

NPI: 1982737201
Provider Name (Legal Business Name): ELIZABETH W. HUTSON MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR SUITE # 150
OXNARD CA
93036-2612
US

IV. Provider business mailing address

1514 ELAND LN
VENTURA CA
93003-6319
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-8460
  • Fax: 805-981-8461
Mailing address:
  • Phone: 310-613-4073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 45220
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: