Provider Demographics
NPI:1912201377
Name:DUDLEY, ANNE E (MSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:E
Last Name:DUDLEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 MARKET ST STE 704
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1630
Mailing Address - Country:US
Mailing Address - Phone:415-902-7226
Mailing Address - Fax:415-626-5820
Practice Address - Street 1:1095 MARKET ST STE 704
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1630
Practice Address - Country:US
Practice Address - Phone:415-902-7226
Practice Address - Fax:415-626-5820
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26877104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker