Provider Demographics
NPI:1932208451
Name:JUDSON, JANICE C (NP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:C
Last Name:JUDSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 255228
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95865-5228
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:9281 OFFICE PARK CIR
Practice Address - Street 2:#120
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-8068
Practice Address - Country:US
Practice Address - Phone:916-691-5999
Practice Address - Fax:916-691-6717
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP2574363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner