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General NPI Number Information
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NPI Number | 1750891446
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Entity Type | Individual
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Provider Name | ANGELA LYNN HUDSON PMHNP, FNP, PHD
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Gender | Female
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 4281 KATELLA AVE STE 215
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City | LOS ALAMITOS
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State | CA
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Zip | 90720
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Country | US
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Telephone | 714-826-2941
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Fax |
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Provider Business Mailing Address
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Address Line | 230 MOUNTAIN CT
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City | BREA
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State | CA
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Zip | 92821-3476
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Country | US
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Telephone | 310-709-8234
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Fax |
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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 | 397230
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License Number State | CA
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