Provider Demographics
NPI:1720250236
Name:HUTTON, ASHLEY SUKIKO (LCSW 72956)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SUKIKO
Last Name:HUTTON
Suffix:
Gender:F
Credentials:LCSW 72956
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:SUKIKO
Other - Last Name:BOYLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4000 W METROPOLITAN DR STE 401
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3506
Mailing Address - Country:US
Mailing Address - Phone:714-954-2964
Mailing Address - Fax:714-568-4933
Practice Address - Street 1:4000 W METROPOLITAN DR STE 401
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3506
Practice Address - Country:US
Practice Address - Phone:714-954-2964
Practice Address - Fax:714-568-4933
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA729561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical