Donald Clutter, PT

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PT15664 Issued in CA

Practice address

212 Carmen LN
Santa Maria, CA 93458-7769

Phone

(805) 205-7680

NPI assigned

Jan 18, 2013

Last updated

Aug 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1205174711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 MESA VIEW DR",
            "address_2": "# 240",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934205548",
            "telephone_number": "760-694-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 CARMEN LN",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587769",
            "telephone_number": "805-205-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUTTER",
        "first_name": "DONALD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-18",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "CA",
            "license": "PT15664",
            "primary": false
        },
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT15664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karmon Jo Cleary, FNP-C
• Amber Clemmons-Trigueros, LMFT
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• Coast Family Practice
• Coast Valley Substance Abuse Treatment Center

• Licensed Psychiatric Technician in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.