Healthcare Provider Details

I. General information

NPI: 1487863080
Provider Name (Legal Business Name): NORI MICHELE HUDSON NC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1952 YOSEMITE RD
BERKELEY CA
94707-1651
US

IV. Provider business mailing address

1952 YOSEMITE RD
BERKELEY CA
94707-1651
US

V. Phone/Fax

Practice location:
  • Phone: 510-847-3197
  • Fax: 510-526-6528
Mailing address:
  • Phone: 510-847-3197
  • Fax: 510-526-6528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: