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Individual

ALISON ANN BOUDREAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2625 FAIR OAKS BLVD, SUITE 1, SACRAMENTO, CA 95864-4936
(916) 646-3376
(916) 646-3336
Mailing address
2625 FAIR OAKS BLVD, SUITE 1, SACRAMENTO, CA 95864-4936
(916) 646-3376
(916) 646-3336

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G076779
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
43-2054849
TAX ID
CA
01
G076779
STATE LICENSE
CA
Enumeration date
03/07/2006
Last updated
03/07/2023
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