Provider Demographics
NPI:1093976763
Name:OGDEN, JUDITH GRETCHEN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:GRETCHEN
Last Name:OGDEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8285
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96158-1285
Mailing Address - Country:US
Mailing Address - Phone:530-544-8580
Mailing Address - Fax:
Practice Address - Street 1:2203 MONTEREY DR
Practice Address - Street 2:
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-6729
Practice Address - Country:US
Practice Address - Phone:530-544-8580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33598101YM0800X
NV0760101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health