Healthcare Provider Details

I. General information

NPI: 1184455586
Provider Name (Legal Business Name): NUDJ HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E GREEN ST STE 11
PASADENA CA
91105-2069
US

IV. Provider business mailing address

101 E GREEN ST STE 11
PASADENA CA
91105-2069
US

V. Phone/Fax

Practice location:
  • Phone: 833-411-6835
  • Fax:
Mailing address:
  • Phone: 833-411-6835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2251C2600X
TaxonomyCardiopulmonary Physical Therapist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: YURI SUDHAKAR
Title or Position: PRESIDENT & CEO
Credential:
Phone: 310-560-5121