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NPI 1376389452

NPI 1376389452 : HALEY HUDSON : FRESNO, CA

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General NPI Number Information
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    NPI Number           |    1376389452
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    Entity Type          |    Individual 
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    Provider Name        |    HALEY HUDSON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/08/2024
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    Last Update Date     |    01/12/2026
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Provider Practice Location Address
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    Address Line         |    1100 W SHAW AVE STE 112 
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    City                 |    FRESNO
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    State                |    CA
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    Zip                  |    93711-3708
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    Country              |    US
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    Telephone            |    559-801-8944
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    155 E SHAW AVE STE 201 
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    City                 |    FRESNO
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    State                |    CA
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    Zip                  |    93710-7619
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    Country              |    US
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    Telephone            |    559-605-4593
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    Fax                  |    559-234-0641
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    95030833
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    License Number State |    CA
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