Basic Information
| Provider Information | |||||||||
| NPI: | 1801511399 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUTCHINSON | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | LEE | ||||||||
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| NameSuffix: | III | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11418 N FOWLER AVE | ||||||||
| Address2: | |||||||||
| City: | CLOVIS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936199544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5593920484 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1470 W HERNDON AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937110552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592562000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2022 | ||||||||
| LastUpdateDate: | 10/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC2200X | N | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | 103TP2701X | N | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy | 104100000X | N | Behavioral Health & Social Service Providers | Social Worker | 106H00000X | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.