Provider Demographics
NPI:1447313259
Name:HUTCHENS, LYNDA I (NCC, MFT)
Entity type:Individual
Prefix:
First Name:LYNDA
Middle Name:I
Last Name:HUTCHENS
Suffix:
Gender:F
Credentials:NCC, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5736 FAIRWAY KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-0981
Mailing Address - Country:US
Mailing Address - Phone:707-591-5364
Mailing Address - Fax:707-566-6986
Practice Address - Street 1:5736 FAIRWAY KNOLL LN
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-0981
Practice Address - Country:US
Practice Address - Phone:707-591-5364
Practice Address - Fax:707-566-6986
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI101106H00000X
CA45407106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist