Provider Demographics
NPI:1548916760
Name:HUTCHINS, LAUREN BETH (PTA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:BETH
Last Name:HUTCHINS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 PASEO BRAVO
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-5714
Mailing Address - Country:US
Mailing Address - Phone:951-719-6851
Mailing Address - Fax:
Practice Address - Street 1:39830 PORTOLA AVE
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-0623
Practice Address - Country:US
Practice Address - Phone:760-972-4580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9764225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant