Provider Demographics
NPI:1730758855
Name:HUTCHINS, VINCENT MICHAEL
Entity type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:MICHAEL
Last Name:HUTCHINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 HELEN WAY
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95776-4227
Mailing Address - Country:US
Mailing Address - Phone:530-761-1609
Mailing Address - Fax:
Practice Address - Street 1:250 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3652
Practice Address - Country:US
Practice Address - Phone:530-379-1393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician