Healthcare Provider Details

I. General information

NPI: 1346603198
Provider Name (Legal Business Name): AVA CECILIA HUDSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 03/21/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20601 WEST PAOLI LANE
WEIMER CA
95736
US

IV. Provider business mailing address

20601 WEST PAOLI LANE
WEIMER CA
95736
US

V. Phone/Fax

Practice location:
  • Phone: 530-637-4025
  • Fax:
Mailing address:
  • Phone: 530-637-4025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN 9252051
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number309763
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: