Provider Demographics
NPI:1609949627
Name:HUDGINS, LOUANNE
Entity Type:Individual
Prefix:
First Name:LOUANNE
Middle Name:
Last Name:HUDGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DRIVE, H-315
Mailing Address - Street 2:ROOM H-315
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5208
Mailing Address - Country:US
Mailing Address - Phone:650-723-6858
Mailing Address - Fax:650-498-4555
Practice Address - Street 1:300 PASTEUR DRIVE, H-315
Practice Address - Street 2:ROOM H-315
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94305-5208
Practice Address - Country:US
Practice Address - Phone:650-723-6858
Practice Address - Fax:650-498-4555
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85295207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG85295OtherMEDICAL LICENSE
CAG85295OtherMEDICAL LICENSE
CAG85295OtherMEDICAL LICENSE