Provider Demographics
NPI:1124198684
Name:HUDSON, ANGELA CHRISTINE (CADC-CAS)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:CHRISTINE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:CADC-CAS
Other - Prefix:MISS
Other - First Name:ANGELA
Other - Middle Name:CHRISTINE
Other - Last Name:GREENWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC-CAS
Mailing Address - Street 1:260 S OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-3927
Mailing Address - Country:US
Mailing Address - Phone:714-776-6090
Mailing Address - Fax:
Practice Address - Street 1:2731 W OLIVE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93728-2449
Practice Address - Country:US
Practice Address - Phone:559-233-5096
Practice Address - Fax:844-337-7303
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACO59920319101YA0400X
CAC059920319101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)