Individual
MR. ANDRE MICHAEL HUDDLESTON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11879 FIRE AGATE WAY, RANCHO CORDOVA, CA 95742-8068
(916) 549-0821
Mailing address
11879 FIRE AGATE WAY, RANCHO CORDOVA, CA 95742-8068
(916) 549-0821
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
171M00000X
CA
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
05/17/2016
Last updated
08/13/2024
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