Provider Demographics
NPI:1073711289
Name:CRAIG, JUDY KAO (MSW)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:KAO
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-3457
Mailing Address - Country:US
Mailing Address - Phone:714-780-0750
Mailing Address - Fax:714-780-0757
Practice Address - Street 1:1901 E CENTER ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-3457
Practice Address - Country:US
Practice Address - Phone:714-780-0750
Practice Address - Fax:714-780-0757
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA22121OtherCA- BBS
069506-01OtherLICENSE NUMBER