Provider Demographics
NPI:1336305861
Name:JUDD, DAVID BILLETER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BILLETER
Last Name:JUDD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23822 VALENCIA BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5348
Mailing Address - Country:US
Mailing Address - Phone:661-437-3287
Mailing Address - Fax:
Practice Address - Street 1:23822 VALENCIA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5348
Practice Address - Country:US
Practice Address - Phone:661-437-3287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24819103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical