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NPI Code Detail

MEDICARE: DR. OSCAR RAFAEL HERNANDEZ SUTTON PH.D.

MEDICARE:  DR. OSCAR RAFAEL HERNANDEZ SUTTON  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY28375CA

General Provider Information

NPI Number : 1700236924
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OSCAR RAFAEL HERNANDEZ SUTTON PH.D.
Provider Business Mailing Address
First Line : 13980 BLOSSOM HILL RD
Second Line : SUITE D
City : LOS GATOS
State : CA
Zip : 95032-5121
Country : US
Telephone Number : 831-225-0213
Fax Number : 408-445-0875
Provider Business Practice Location Address
First Line : 13980 BLOSSOM HILL RD
Second Line : SUITE D
City : LOS GATOS
State : CA
Zip : 95032-5121
Country : US
Telephone Number : 831-225-0213
Fax Number : 408-445-0875
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2016
Last Update Date : 06/18/2016

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Directions to “ DR. OSCAR RAFAEL HERNANDEZ SUTTON PH.D.” Practice Location

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