Provider Demographics
NPI:1336444801
Name:HUTCHINSON, STANCIL JOSEPH LISTER (PSYD)
Entity type:Individual
Prefix:DR
First Name:STANCIL
Middle Name:JOSEPH LISTER
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 ALHAMBRA BLVD.
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816
Mailing Address - Country:US
Mailing Address - Phone:916-849-6251
Mailing Address - Fax:916-444-4451
Practice Address - Street 1:730 ALHAMBRA BLVD.
Practice Address - Street 2:SUITE 205
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816
Practice Address - Country:US
Practice Address - Phone:916-849-6251
Practice Address - Fax:916-444-4451
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 23928103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical