Provider Demographics
NPI:1477745685
Name:TRIX, JOHN JUDSON (MS, RN, APRN-BC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JUDSON
Last Name:TRIX
Suffix:
Gender:M
Credentials:MS, RN, APRN-BC
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Mailing Address - Street 1:1450 TREAT BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2168
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:
Practice Address - Street 1:122 LA CASA VIA STE 120
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3019
Practice Address - Country:US
Practice Address - Phone:925-941-4058
Practice Address - Fax:925-941-4049
Is Sole Proprietor?:No
Enumeration Date:2007-08-11
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA17156363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner