Provider Demographics
NPI:1205822343
Name:HALL, JUDITH ANN (NP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:HALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:ANN
Other - Last Name:LINDHEIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 11949
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92685-1949
Mailing Address - Country:US
Mailing Address - Phone:866-883-5374
Mailing Address - Fax:
Practice Address - Street 1:1100 BUTTE STREET
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0852
Practice Address - Country:US
Practice Address - Phone:530-244-5400
Practice Address - Fax:530-241-9604
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13792363LF0000X, 363L00000X
CARN327957363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN327957Medicaid
CARN327957Medicaid
CAZZZ04368ZMedicare PIN