Provider Demographics
NPI:1902151467
Name:BUTLER, HANNAH (MA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:CARDONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 W TOWN AND COUNTRY RD STE 1250
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4633
Mailing Address - Country:US
Mailing Address - Phone:805-501-9929
Mailing Address - Fax:310-337-7840
Practice Address - Street 1:4880 MARKET ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7783
Practice Address - Country:US
Practice Address - Phone:805-644-7827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81427106H00000X
390200000X
1-17-27257103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-17-27257OtherBEHAVIOR ANALYST CERTIFICATION BOARD
CA81427OtherBOARD OF BEHAVIOR SCIENCE