Healthcare Provider Details

I. General information

NPI: 1639027964
Provider Name (Legal Business Name): MS. DANESITY JEAN LUDDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3628 MADISON AVE
NORTH HIGHLANDS CA
95660-5069
US

IV. Provider business mailing address

3628 MADISON AVE
NORTH HIGHLANDS CA
95660-5069
US

V. Phone/Fax

Practice location:
  • Phone: 916-388-3231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: