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General NPI Number Information
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NPI Number | 1922459478
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Entity Type | Individual
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Provider Name | GABRIELLE LORRAINE HUDSON MSW
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Gender | Female
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Dates
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Enumeration Date | 06/27/2016
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 1680 E 120TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90059-3026
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Country | US
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Telephone | 424-338-8672
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Fax | 424-338-8962
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Provider Business Mailing Address
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Address Line | 1319 CYPRESS AVE APT 3
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City | LOS ANGELES
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State | CA
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Zip | 90065-1269
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Country | US
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Telephone | 424-338-8672
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Fax | 243-388-9624
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW90242
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License Number State | CA
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