Individual
ANNALYCIA VICTORIA HUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3517 CAMINO DEL RIO S, SAN DIEGO, CA 92108-4026
(619) 955-8905
Mailing address
1536 MOORLAND DR, SAN DIEGO, CA 92109-6675
(916) 897-3289
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-BGEYNR
CA
Other
Enumeration date
12/01/2020
Last updated
03/28/2024
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