Provider Demographics
NPI:1831448273
Name:HUDSON, ASHLEY (MA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18891 VIA ENCANTO
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-4123
Mailing Address - Country:US
Mailing Address - Phone:714-329-5842
Mailing Address - Fax:
Practice Address - Street 1:300 S C ST
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3633
Practice Address - Country:US
Practice Address - Phone:714-730-7301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68427101YM0800X
CA83507106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health