MEDICARE: TAMI JUDSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760928824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMI JUDSON

Provider Business Mailing Address
First Line	:	7806 UPLANDS WAY SUITE A
Second Line	:
City	:	CITRUS HTS
State	:	CA
Zip	:	95610
Country	:	US
Telephone Number	:	916-870-2621
Fax Number	:

Provider Business Practice Location Address
First Line	:	6060 SUNRISE VISTA DR STE 2100
Second Line	:
City	:	CITRUS HTS
State	:	CA
Zip	:	95610-7068
Country	:	US
Telephone Number	:	916-870-2621
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2017
Last Update Date	:	09/05/2025

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Directions to “ TAMI JUDSON ” Practice Location

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